HomeMy WebLinkAboutDrain Layers Permit 972 Pleasant Valley (2) 750061 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 10/09/07
GIS ID: 72900972
- FEE:
60.00
MUNIS APPLICATION# 200701646
€ E
XPIRATION DATE:
11/08/07
AP PLI C A N
::LO
CATION TI O N
NAME: �: ....
JAMES THROWE DBA" r:^.::...:: : >< D,..
4.:°: y�:°: RESSk.�` ;.9;7�PI,E�SANT VALLEY ROAD
ADDRESS: 97 RIVERSIDE DRIVE
VERNON ROCKVIL
P �.
rDSOR,CT 0 6074
PHO
NE
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W O RK DES
CRIPTION:
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THE DRAIN LAYER ASSIGNED TO THIS ERMZT -E STATE AND HEREB
Y AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTI III):A( Tr` "`C15'"`A 1 }?V( {SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDAI�DS''ALL` tfiTACHED CONDITIONS.
ISSUED BY DATEIN UTED INSPECTED BY
10/9/2007 3:30 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 7S006 / CONTRACTOR: 'Tay),_'S
LOCATION:_ (V /2d
TYPE OF WORK:_
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:_ 15D
WORK IN
PROGRESS:— C ,.�, U�o✓ s ,G��� e�1 �-�,L /may �� I�a
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DATE:_ A, ._ a
W/2007 Town of South Windsor INPSECTION REPORT 07
loerm,t-=# 7SOOCI
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
cP pl aD0�0/�;�6 PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of work: 9 7 �'P-� VC'1 J-Lot #
proposed
Street No. Street Name
Premises owned by:
Name of Firm: Y o'( Phone: 200o -
Address of Firm:
TYPE OF WORK:
Lay House Drain_; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with S b2 3Sr
Existing Water Supply: Public Water Well
Proposed Start Date 10-10--07 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 �avKekS r�"`'`� the holder of Drain
Layer's License No. 26MY9 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. Al and/or ConnDOT Permit No.
J
CBYD No. Zoo7 ` QZ 5�b
Signed: Print Name:
Licensed Drain Layer
Date: C�C G
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: l �1 f -
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TOWN STATE ZIP INSPECTED BY TOWN
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`TELEPHONE NUMBER
- TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER