HomeMy WebLinkAboutDrain Layers Permit 33 Beelzebub Road PERMIT TOWN OF SOUTH WINDSOR
0063
PERMIT NUMBER , CT
DRAIN LAYER PERMIT
DATE: 10/10/07
GIS ID: 09000033
'ky.:
MUNIS APPLICATION# 200701653 FEE:
60.00
EXPIRATION DATE:' N
11/09/07
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C A TI O NAME JAMESTHRoWEDBA S ?::ADDRESS: 97 RIVERSIDE DRIVE . ELEBU ROAD
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HE TERMS AND CONDITIONS SET FORTH i II�l<'1i A TSUED "Tfm TTE AND HEREBY AGREES TO ALL
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THE TOWN OF SOUTH WINDSOR STANDA ]p'S"pXI F' 4S RK
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10i10i2007 9:18 AM INSPECTED BY
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR:
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: a ; o 7
INSPECTED BY:- p
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INPUT: DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
Perms, # 7SO063
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKSDEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: 32 &g� LL R o(, Lot #
Street No. Street Name
Premises owned by:
Name of Firm: �r- �,c , ��/� zZ Phone:
Address of Firm: P)' 1L' Jr, ern e)
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 . 3�
Existing Water Supply: Public Water Well
Proposed Start Date 15 XT Estimated time for completion 150&7-
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CO7017
ATTACHED TO THE PERMIT
Permit is to be issued to Yht 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.
Signed: Print Name: r7)MA,
Licensed Drain Layer
Date: 5 o f) G:)
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH NDSOR
SANITARY SEWER LATERAL FIELD.- LOCATION
DATE� OF CONSTRUCTION: Z& -�6 7
BUILDING .ADDRESS
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STREET
- SUBDIVISION:
NORTH ARROW
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17
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CONTRACTOR (PRINT) NA�� POF ONTRACT SUPERVISOR (PRINT)
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STREET ADDRESS 7RE l
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TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN: PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER