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HomeMy WebLinkAboutDrain Layers Permit 223 Maskel Road (2) 750065 1 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER 'y`i`" ; '• DRAIN LAYER PERMIT DATE: 10/10/07 't> �• '' GIS ID: 57900223 MUNIS APPLICATIO N# 200701 ��` FEE: 60.00 659 r « �. XP IR A TI O N DA TE:TE• 1 1/0 9/0 7 APPLIC NT NAME: E : % K, `< OC AGLE EARTHWO .k,. w >: ATION ADDRESS ° RE `::: :. `.: 101 N MOUNTAIN Rp MASIEL ROAD 9,:.> v7VA+} ..v. CANTON 3 Al2T0 BUILDERS CT 06019 �>�° INC >.. fl. MAY AI.RD#3- F PH ONE O w NE UfiH'�VVI�TD 860- SOR CT 06074 a.:ff:v .•Y Yf' tsue:WORKDSCRIPTION: INSTALL: >i : THE DRAIN LAYER ASSIGNED TO THIS PF THE TERMS AND R1k I Ht S`A VA::"" CONDITIONS SET FORTI : NA .: S1ATE AND HEREBY AGREES TO ALL THE TOWN OF SOUTH WINDSOR STANDARDS,^"'LE1oshik. �".` �L WORK SHALL BE IN ACCORDANCE WITH Q iD'711 ATTACHED CONDITIONS. SUED BY DATE INSPECTED 10/10/2007 11:55 AM INSPECTED BY TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: CONTRACTOR: LOCATION: ADDRESS: TYPE OF WORK: DATE INSP NEEDED: DATE INSP: 1 a/66,©7 INSPECTED BY: /3 WORK IN PROGRESS: /'�, �.�� Z.--4 �P®,J c, �' Pao— S a2 SS7-�Lk, 1 t 1 Q 4-. CraN-s �>I-onlai /l�Y10 �tif'ra .N , ire INPUT: DATE: I(�) 0'U Zoo�91�� 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: 221 104 4C, y1 z Lot # Street No. Street Name Premises owned by: AaftnVAh4Q &6'& Name of firm: kWCy' Phone: z Address of Firm: Al U t OuvV{zs iu TYPE OF WORK: Lay House Drain_; Repair House Drain ; Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with 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 27 9 M� the holder of Drain Layer's License No. . 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. i Signed: Print Name: Licensed Drain Layer Date: Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc s• � ter�,��r�r�► ., �r'� --.��, �, ice ''��I , '��'`'' �:� �,.�,-- �� ■ Wil . , I� r �•