HomeMy WebLinkAboutDrain Layers Permit 192 Maskel Road (2) 750073 TOWN OF SOUTH WINDSOR, CT
PERMIT N JMBER DRAIN LAYER PERMIT
DATE: 10/23/07 r'
GIS ID: 57900192
MUNI S AP PL IC AT N# 200701739y�`
FEE
:
60.00
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IR.ATI O ND DA
TE:
1 1/2 2/0 7
APPLICANT:
`, ,4b>�;;::' LOCATION
NAME: EAGLE EARTHWORVf
s L ROAD
ADDRES
S: 101 N MOUNTAIN ROA4
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CT 06019
R ,;' TI'�A�C2r1�T0 BUILDERS INC
CANTON
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U ... ITD
SO CT 06074
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LCWORKDESCRIFTION: NEWSEVE
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THE
RAIN
LA
YER
RA ASSIG
NED TO THIS h
A TE
THE TERMS AND CONDITIONS SET FORTH& ITS AND HEREBY AGREES TO ALL
7 '"fI WQI�K SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STAND ARIS �AI,IpSA,; TJ
15 AiVT);: IE>ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
10/25/2007 2:12 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:Zn2Q7 3 CONTRACTOR:
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: !d _
INSPECTED BY: 9 P
WORK IN
PROGRESS: �'v� s®rz 3 bra
AS-BUILT:
INPUT: DATE: "
W/2007 Town of South Windsor INPSECTION REPORT 07
��rw► "� 7SG0 73
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
qi /-a# aoO701 7-3 PUBLIC`7 WORKS DEPARTMENT
Pf TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: ke s"40f ) Lot #��
Street No. Street Name
Premises owned by: AJA4 R r,`�t Ot/�����
Name of Firm: li° LrfT h �di��C Phone: 3--06Z 7
Address of Firm: I A)
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 the holder of Drain
Layer's License No. 2 -7 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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