HomeMy WebLinkAboutDrain Layers Permit 208 Maskel Road (2) , 750074 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
DRAIN LAYER PERMIT
DATE: 10/23/07
GIS ID: 57900208
FEE:
MUNI 6 S 0.0 APP 0
LI C AT IO N# 2 0 07 O1 74 0
XP`<E IRAT IO ND AT
1 1/22/07
APPLICAN I
NAME: EAGL 5F£`: LOCATION
E EARTHWORK SF,�U%,- Y '`h;
ADDRESS: MA KE ROAD
101 N MOUNTAIN R(3 >'�x::�`` kr``�yx; `" ;�': ;
CANT MO BUILDERS INC
ON,CT 06019 u:'"
PHONE ; H,., :. VITDSOR,CT 06074
860-693-2027:;
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THE DR
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THE TERMS AND CONDITIONS SET FORTI wII�F CIE AW*CIT TfC >s�A: AI L" Q1 K SHALL BE IN ACCORDANCE
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THE TOWN OF SOUTH WINDSOR STANDART ,rYI OS 1�ArQUI3E1vFS ,� '; E,ATTACHED CONDITIONS. WITH
ISSUED BY DATE INSPECTED' INSPECTED BY
10/25/2007 9:54 AM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:_ CONTRACTOR: '
LOCATION:_ �?� Vn2�kc•f� Q _..._..._
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:_ 1 o/III_/01
INSPECTED BY:_ 8 b
WORK IN
PROGRESS: ��n�►-a��r i� h®� Ayc, sble 5
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AS-BUILT:_
INPUT: DATE:_ 7 D JS
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
a61p70/7tf(� PUBLIC WORKS DEPARTMENT TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: ;?6 fros/ce/ P-0 Lot #�(
Street No. Street Name
Premises owned by: Almilgrl'"
Name of Firm: &)0 J2 Phone: '�zc�2
Address of Firm: LO �� � �—��`'
TYPE OF WORK:
Lay House Drain K ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with r v
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 the holder of Drain
Layer's License No. 2 7 9 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:
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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