HomeMy WebLinkAboutDrain Layers Permit 93-95 Evergreen Way PlInnt Ph,
Peelle Deal 11/14/�GGG
at Beath
...,. xxs'raec's".��';ar` N S �oD:ie .r<D eeDA1e . �.
Appill
eN... KESSLER DONE
, » m,n Ewa
� na .e
peek d.86 ,aa 6 �,.eW�
ae
The Sell. Bay, Den,
yLate and hereby d by the
d By
.OW„ OF soOLD W,Wo.oE INSPECTION AEFURT 0
'Maw 9G yq u Co(.
Type Weak NEW S LOT
dGi
Date Inap Heeded
F 1 T'ae LISPNeeded
I end
al...a By i
WIDE 11 Is... _ cp.J Fe t- . .r
rsc+_x sdU.b + the
�. < t
p
4 a11(5
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: V3 v' 9S IAAnEK-t- AVC Lot #
Street No. Street Name
Premises owned by: 'V .#A&'.d '�
Name of Finn: kZ--0/.M /%4&29W;r, I Phone:./`' L 019
Address of Firm: L�/f.P?�,( ;7- di:2B2
TYPE OF WORK:
Lay House Drainer Repair House Drain
Lay Main ' Lay lateral for Commerclal/IndusMal
Building of acres
Connection will be made whh
Exisbrig Water Supply: Public Water Well
Proposed s a Da -jl ESUMAed Ome for completion 1 '
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 - ' �/�+� the holder of Drain
Layer's License No. 1& S> Only hollers M P-1, P-] or W-9 licenses
will be Issued a permit. PERMIT WILL WHILE THIRTY (30`}"9TA'YS AFTER
DATE OF ISSUANCE. The undersigned Drain layer hereby agrees to all Me terms
and conditions set forth in the permit and aUached thereto. Applicant has received
Town Street Excavation Permit No. and/or Cum-DOT Permit No.
CBYD No. :JdB/ii Pr3Oa7d7.25'�/'
Signed:
ce nse n
Print Name: �8EQwf
D _ WRYE 'vn
i@MR.tlz
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS 95 " io� 4
STREET :
GSUBDIVISION:
E.-r-y 4 //r - /Xwre Z
NGRTH ARROW
_ _ I
4 5 `
I'
eecrle— o.-u><. c-s/o . /mob<—f Ta ��✓
C0.4DUCTOR (PRINT) � WME OF WNDNCiOR'S SUPERASOR (PPoND
STREET pL9fd:.SS ' NAE
TOWN - STATE ZIP WEOTED BY TGWN
603 -oA 3a DATE
TEIkPHONE NUMBER
ME - TOM PINK.- WMRACttIR Y W - WNSUUING ENGNEEH / DEVELOPER