HomeMy WebLinkAboutDrain Layers Permit 1523 Main Street (4) TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7033 Contractor GARRISON SAND & GRAVEL INC.
Location 1523 MAIN STREET Address 278 PALMER ROAD
Type Work NEW SAN LAT - CHAPLIN CT 06235
Phone No. ( ) -
Date Insp Needed C
--�---------- Date I n s p ---- ----------Time Insp Needed ' �1 Time Insp.
Inspected BY
Work in Progress
Input —,-----------_-____-� Date
i
a
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Location of proposed work: ✓�"L �, S: Lot #
Street No. Street Name
+ 9 7
Premises_owned_by: / -J4,11 c s
Name of Firm: ` �� 11.��;:� ;.t ;�,
Address of Firm: 5�.3 C - 60. 3, -
TYPE OF WORK:
Lay House Drain V ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
rs
Connection will be made with '3
Proposed Start Date `' Estimated time for completion ' f '51
i
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to 1_:� =L��.1 � 1- � >2 the holder of Drain
Layer's License No. .,,,(-: cy<� (;c;L Only holders of P1, P7 & W9 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.
Signed: Print Name:
Licensed Drain Layer
Date: s' `l
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc