HomeMy WebLinkAboutDrain Layers Permit 14 Wildlife Trail Permit No. 8037 Town of South Windsor, CT
Permit Date 03/16/2006 Drain Layer Permit
Expiration Date 04/15/2006
Descrip:
Applicant p
li can t
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Name F OL SOM CONS
UC ;Y
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Addr. 138 RYE STREET
owner... r
SOUTH WINDSOR T 06LL7k
Phone No. (860) 528-6928 t
The Drain Layer.. assgned this pn�t liar valid license issued by the
state and hereby agrees tb a1 :<:the tkl';- S,ari€ ' O'ndi> sjon5 :Set fo:Yth in the
attached 'Conditions' All work -s131 }� _ - 4riceTAwn of South
Windsor standards, a31'bSHA.requ 'remen gt a t .Che e :t ched,..cAnditions.
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Issued B
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Date Inspected ----- Inspected By
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TOWN OF SOUTH WIND INSPECTION REPORT
Permit No. 8037 ColaCrac.tor $QLSQM CONSTRUCTION LLC
Location '' .. .' Addtes.s s 1:3.8 1�X STREE:T
Type Work NEW SAN LAT `t jUTL WII3g8QR>CT 06074
Phone-Np (86fl<)B�8- 8928
Date Insp Needed
---—-------- -r 15 t L� V
Time Insp Needed Time
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Inspected By
Work in Progress _�6+a �✓tc .' s
------------------------ $w.,OIL Ape
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Input'::.. -----::Date
TOWN OF SOUTH YINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS '¢
STREET
SUBDIVISION: , 'fie - 4.r/,K:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S S ERVISOR (PRINT)
STREET ADDRESS GNATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
5� b DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
. 7
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: 41V-1141114
Lit #
Street No. Street Name
Premises owned by:
Name of Firm:_/ �� Phone; 5 AP-09z 45
Address.of Finn: �-�� ✓ .�'�>�
TYPE OF WORK:
Lay House Drain Lay Mai Repair House Drain
n � % -
Lay-Lateral-for Commerdal/Industrial
Building of acres
Connection will be made with 5.D/e
Existing Water Supply: Public Water Well
Proposed Start Date-`1S Estimated time for completion .3 /s
A11 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 e5w , •� the holder of Drain
Layer's License No. low Only_holders of P-1, P-7 or W-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 received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No.
Signed: Print Name:
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc