HomeMy WebLinkAboutDrain Layers Permit 60 Woodside Drive 750044 TOWN OF SOUTH WINDSOR, CT
Y PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 08/20/07
GIS ID: 97500060
MUNIS APPLICATION# 200701324
4:<> FEE: 60.00
EXPIRATION DATE:
09/19/07
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APPLICANT
LOCAT
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NAME: SKIPS SEPTIC
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60liftODSIDE DRIVE
ADDRESS: 27 MUDDY BROOK ROAD. <` ? ' "':'`
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CT 0602
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THE DRAIN LAYER ASSIGNED TO THIS IEMIT` >.:YA
I Iw13 BY3 "ST E AND
F A. HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORT ,IN TH�4 A;7AC 1;r t IyS°. ;t L'WORk:SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDAirDg :—LL"OOSH-A;R ; r ACHED CONDITIONS.
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ISSUED BY DATE«. INPEC`IED;.:.... INSPECTED BY
8/20/2007 10:14 AM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR:
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: oz a7
INSPECTED BY:
WORK IN
PROGRESS:
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W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
`�pPJ # dao7o%� PUBLIC WORKS DEPARTMENT
Y : TOWN HALL
1540 SULLIVAN AVENUE
f' SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work 7z-- Lot #
Street No. Street Name
Premises owned by: TZ/c lc '7Z.1Oct X
Name of Firm: Te tPS �S£PT1 c— Phone: ?��33
: .. Address of Firm: Bo X 2-9 — Pj 07V^j
TYPE OF WORK:
Lay House Drain X ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with PVC S,)/C 3 S—
Existing Water Supply: Public Water Well
Proposed Start Date Estimated time for completion
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 'Jrftl i G.d L-A--V X, the holder of Drain
Layer's License No. 70 11 Z 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. c;700 , 330 3 3 9,9
Signed. Print Name: tI S
Licensed Drain Layer
Date:
standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: cry
BUILDING ADDRESS 60, Gd s,,'�e. r , 5% Lj
STREET .
SUBDIVISION:
NORTH ARROW
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CONTRACTOR RINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
TOWN STATE ZIP INSPECTED BY TOWN
- s T5 7-3,;Z- DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER