HomeMy WebLinkAboutDrain Layers Permit 31 Summerwood Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
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APPLICATION FOR DRAIN LAYER PERMIT "
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALT.
1540 SUUJVAN AVENUE
SOUTH WINDSOR, Cr
FEE $60.00
Location of Proposed work:�1'
I, II Street No. Street Name
Premises owned by:—AxacAle / - QS{
Name of Firm:
Address of Arm• o
TYPE OF WORK:
Lay House DMin '. Repair House Drain
. Lay Main . . Lay Lateral for Commercial/Industrial .
Bulldirg of__aaes
Connection vAn be made with
Ebs0ng Water Supply: Public Water Well
proposed Stan DNS/ Esymatetl tlme for mmla�on S U'
AU:WORKTOBEIN WITH TOWN OFSOIfiH wINDSO ST ARD$,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT Permit is t0 be Issued to n9,�
layer's NcenseNo. �(�-2 �,q K Only falde of 7 w Wr-9 Drain
abe Issueda perm lnew1T gnedl)raln THIRTY(30) AYS AFTER
DATE OF ISSUANCE. The untleisigeed Dmin Layer hereby agrees to all the terms
aM condidonsset f0dh in the permit and attag thereto. Appilcant has received TOvm Shea Bx vauon Permit No. and/or ConnDOT Permit No.
:CBYD NO. ✓-2- / /
Slgnetle Print Name
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: �GN/I l`L OJ.°w(�N
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Date:
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