HomeMy WebLinkAboutDrain Layers Permit 93-95 Tamarack Avenu , IT
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN BALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: %3 c' 75 IAAAEK— AvC Lot p
Street tree�No. Street Name
Premises owned by: �,& ,�lr&yd/ 4yzr0Meh z&Ji'--nn��''nn
v1,n2 Name of Hrm: ,t�.Ers'la�P /'.¢PiS'jRI ,E� 0, Phone:PjaS
Address of Finn: dee;Z&�� I-Iyj �(�7— dlYa6
TYPE OF WORK:
lLay, House Drain ; Repair Hoarse Drain
Lay Main Lay Lateral for Commercial/Industrial
Building-- was
Connection will be made with
ExMing Water Supply: >�Puub_lic Water Well
Proposed Start Date ////3//�6_.. E-5timated gme far avnp�im
ALL WORK TO BE IN ACCORDANCE WITH TOW14 OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit N ro be issued,to the holder of Drin
Lai License No. X —. Only holders of P-1, P-] a W-9licenses
will be 'ssued a permit PERMIT WILL IXPIRE THIRTY (34YDAYS AFTER
DATE OF ISSUANCE. The undersigned Drin layer hereby agrees to all the terms
and conditions set forth In the pmnR and attached thereto. Applicant has received
Town Stream Excavation Pant No. and/a ConnDOT Permit No.
CByDNo. aB/n' f 0,Z25�7
Signed:
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Date:�fry/6
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: IZ- /b-oLo
BUILDING ADDRESS s
STREET
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