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HomeMy WebLinkAboutDrain Layers Permit 100 Mark Drive Ui v I e 4c S,I Yesf�r�- s Id 2G�S � low F.23�8-i q� / loo �2,'K D 77 o'\ .j a APPLICATION FOR DRAIN LAYERS PERMIT TOWN.OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE$25.00 9� lrC;7� Location of proposed work ` (570 Lot # Stre t No. Street Name 00 Premises owned by: Name of Firm: ' Phone: a2z2'5W eC- Address of Firm: TYPE OF WORK: Lay House Drain �� Repair House Drain ; Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with C &411-- Proposed Start DatefO �lEstirrated timefor completion. lD 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 issu to O- the holder of Drain layer's License No.W 4 **41j . . 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. Signe Print Name l/I ICJ Lf sc L lre,s Licensed Drain Layer Date: s TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 6486 Contractor SILVESTER VIOLETTE & SONS Location 0100 MARK DRIVE Address 65 CHERRY STREET Type Work NEW SAN LAT EAST HARTFORD CT 06108 Phone No. (860 )289-3466 Date insp Needed im,�� Zy� _ t?ate �In6p —1�z_/4� Time Insp Needed �xntisp i Inspected By T t. �i :✓G" _ Work in Progress L1r. Ef .-, _- A& Inpu>~ Date f: \ { Permit No. 6486 fa" Town of South Windsor, CT Permit Date 10/01 / 1996 $' Drain Layer Permit EXpiration Date 10/31 /1996 De�§crip : CK985$750, CK14861$25 Applicant Location Name SILVESTER VIOLETTE & SONS Addr . 0100 MARK. DRIVE Addr. 65 CHERRY STREET ;Owner M"ESSINO JEAN M ; EAST HARTFORD CT 06108 Phone No. (860)289-3466 The Drain Layer assured",thjs Petrol has 4 'v'aVi"d_ l i'cense issued by the state and hereby agrees t©" .a "the terms and cora"dit ans set forth in the attached 'Conditions ' . All " w4"r'k shal-1 `be %n ac' r.danc.e with Town of South Windsor standards, all OSHA`,`refit ir6ments,' and the .`attached conditions. Issued B y � ' T i t-1 e .��? �' Date Inspected _10 9 Inspected By " t-J