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HomeMy WebLinkAboutDrain Layers Permit Pheasant Way Extensi 6' Permit No. 7052 Town of South Windsor, CT Permit Date 09/20/1999 Drain Layer Permit Expiration Date 10/20/1999 Descrip: RELOCATE SEWER MANHOLE Applicant Location Name JMJ CONSTRUCTION CO Adr .` PHEASANT WAY EKTENSION Addr. 658 ELLINGTON ROAD 01whe,�^ SOUTH WINDSOR CT oO, .7, . . ': Phone No. (860)528-7889 , . The Drain Layer assgnec ttii srr �t .has 3 c�. I cense issued by the state and hereby agrses t+ .. s,�°l t r�:�k�and4ti �iri� s set forth in the attached 'Cond i t ions ' % ,.acc©°rdriae with Town of South Windsor standards, cements .,attached conditions. Issued By J. �. 0 A Date Inspected Jar- Z 3 �5',Q Inspected By APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR PUBLIC WO RKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Location of proposed work: s'(/�� T Lot * St eet No. Street Nam Premises owned by: AT 6'ylo 4 Name of Firm: Phone: 06'aO Address of Firm: TYPE OF WORK: Lay House Dr ; Repair House Drain Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with rk (" Proposed Start Date _a 0 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 v�S &, the holder of Drain Layer's License No. a0d8.3 U Only holders of P1, P7 &W9 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. Signed: Print Name;_Z � r /1� icen Dra' ayer Dater'—off Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc