HomeMy WebLinkAboutDrain Layers Permit 38 Summerwood Lane TOWN OF SOUTH WIND$OR 10SPSCTION REPORT
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work:.y8 .nn r, I, a - Lot # �
Street He.
Street Name
Premises owned bby: o cstb ,
Name of Firm! l 4L2 c l�(10 p T
Phone:--)(o o�G�' .
TYPE OF WORK:
Lay House Drain Repair House Drain -
: Lay Lateral for COmmerdal/Industrial
Building of acres - -
Connection will be made with 61
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Bdsting Water Supply: Public Was
Proposed Start Date b L9 L Estimated time for completion U C, U.
ALL WORK TO BE IN ANCE WITH'TOWN OF SOUTH WINDSOR ANDARD.S,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permitis to be Issued to I CSL r a � CO the holder of Drain
Layees Ncensd NO. 7 u)t % [ . Only holders of P-1, P-7 orW-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 receiyed
Town Street Lkcravation Permit No. and/or ConnDOT Permit No.
CBYD No. i' v A Signed:
*Jm7n�dPrint Name: cIJ4 CUP J/
4miner
Date: ) 6 0
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