HomeMy WebLinkAboutDrain Layers Permit 39 Wildlife Trail (2) 750023 TOWN OF SOUTH WINDSOR, CT
PERM-dr NUMBER DRAIN LAYER PERMIT
DATE: 07/06/07
GIS ID: 94400039 '
�� `` FEE: 60.00
MUNIS APPLICATION# 200701039 `% ' . EXPIRATION DATE:
`:,` r y`" E: 08/05/07
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NAME: FOLSOM CONSTRUCT:OI :. T .,,'....
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ADDRESS: 138 RYE STREET �'';a:3: `r ..;. ER:> ;;WkNER MEADOW LLC
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THE DRAIN LAYER ASSIGNED TO THIS P, IT�It S,A:>uA�1, �Su Dm3: <:THE SThELIREiBAGREES TO ALL
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THE TERMS AND CONDITIONS SET FORTH IN,T- H s: TTAC. `I F p1 S°,.,<; ,� VV( RK�SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDAI yALI A%� "'�jI'S�AANI7 TAti;XT'ACHED CONDITIONS.
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7/6/2007 3:37 PM ISSUED BY DAT8 TNSPECTED INSPECTED BY
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: ,3 CONTRACTOR:
LOCATION: / f'� �U /(
TYPE OF WORK: (0,ck)
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:
AS-BUILT:
INPUT: DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
/ TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: W i 4:::�- Lot #
Street No. Street Name
Premises owned WA" U,04 AArF
Name of Firm: t,h Ph ne:
Address of Firm 1),4 UAL
O
TYPE OF WORK: --��`—
Lay House Drain ; Repair House Drain
y ain ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
-- -- Existing Water Supply: 5�Public Water Well
Proposed Start Date Ve Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS Ali CHED TO THE PERMIT
Permit is to be issued to ® Sty �G� the holder of Drain
Layer's License No. 0 Only holders of P-1, P-7 or W-9 licenses
will be issued a permit. PERMIT WILL EXPIRE THIRTY(30) DAYS-AFTER
DATE OF ISSUANCE. The undersigned Drain Layer hereby agrees to all the terms
and conditions set forth in the permit and attached thereto. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No.4 Um
Sign 0/774:14 Print Name:
censed Drain Layer
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Date: - `�U-7
Standard Foams\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAV FIELD LOCATION
DATE OF CONSTRUCTION: 07
BUILDING ADDRESS
STREET Tat L
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
SUM 'GGa �' 1
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STRrET ADDRESS SIGNATURE
DATE
_ TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER