HomeMy WebLinkAboutDrain Layers Permit 35 Tamarack Avenue PIT." No a106
OWN OW CANAL WindooV, CT
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INSPECTION REPORT
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULUVAN AVENUE
SOUTH WINDSOR, Cr
FEE $60.00
Location of proposed Lot s
A Street No. Street Name
Premises owned by: Adlif J,y'Flr"
Name of Firm: nm,(m/CYdA>IEnH{i�V//� Phone: An-?d6'005
Address of Hrm: ay/�{. /JH&' ffj1Q/f 4 EYggi/rl
TYPE OF WORK:
Lay House Drain— Repair House Drain
Mala.2 a Lay Lateral for Commertlal/Industrial
BmIdl q of _ acres
Connection will be ma +ritlF Nr//��.h`AAF1�01 `4.G1/7JJ�`fJ7d Ydct2d
Existirg Water Supply:: Public Water_ Well
Proposed Sb Trt Date /F//J�,,O/OPo Fstirra[el time for mmpletlon 2 A
ALL WORKTO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
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Permit is to be Issued to.¢ OernAk?i "V Only ' � of the holder W of Drain
Layer's License No. JnSSdB . Only holders of P-lW Y W ffEInses
will IE Issued]IS a permit. PERMIT WILL IXain L THIRTY y agrees
to AFTE0.
DATE OF ]ISSUANCE, Thee permit
Drain Layer hereby agrees to all the terns
To conditions set fwM In the p o. a plbdled ticeand/ r Conn Ohas received
Town S Excavation PermR No. _/� and/or Conn00T Permit No.
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CBYO No. >ZtO6Y '7,tai7
S9pffiP' rz ' Print Name:AW. Az:--J�(b�/71.14T/I.LX-
Licensed Drain Laof
Date: 1!�' pl
SMArJ tams\PenN6WVUGlION FOR ORVN IpYE16 iIXMRAa
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