HomeMy WebLinkAboutDrain Layers Permit 44 Wildlife Trail (2) Permit No. 8039
Permit Date 03/16/2006 Town of South Windsor, CT
Expiration Date 04/15/2006 Drain Layer Permit
Descrip:
Applicant
Ioe:ation
Name FOLSOM CONSTRUCTION TLC
tdd ERYJAL�C LIMIT -11
Addr. 138 RYE STREET
SOU
TH W INDSOR CT_ QG07q'
Phone No. (860)528 892$,
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e Drain La yet a s s i :.:..
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state P>. ::...,:. a val>:dc:ense:.::. sued b to and hereby
a`. y the
heexmsdonc� tans set forth in the
attached 'Conditions' . A } Wpm} -'shall :.b ,;zn.:.aCc.orcc.e..:with 'iawn of South
Windsor standards, lY pSF1�...retu�r:g#*.11., ,and the- a'ttabhei..caizditions.
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Issued By ------ Tit
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Date Inspected t
ed
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TOWN OF SOUTH WIND :SIN ECTION REPORT
Permit No
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Location Ch '� Address. s8 RYETFd.ET.
Type Work NEW SAN LAT SQU3H WINDS(12;CT:::.06074
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Date Insp Needed
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Time Insp Needed rX
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Inspected By p
Work in Progress _
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Input _.:Date
TOWN OF SOUTH ANDSOR
SANITARY SEWER LATERAL FIELD - LOCATION
DATE. OF CONSTRUCTION:
BUILDING ADDRESSr �
STREET
t� SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUP SOR (PRINT)
1?45 le
STREET ADDRESS NATURE
,�-" l.+j/�•�./`o �' �7t I�i.enM�`� DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE -:TOWN -, PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
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APPLICATION FOR DRAIN LAYER PERMIT L
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: � � ,/Lot # 6el.,fl/
Street No. Street Name
Premises owned by:
Name of Firm:_ o Cc� ,,� Phone• �� -WZ5'
Address.of Frm: � f't /`c�� c,C
TYPE OF WORK:
Lay House Drain Repair House Drain
Lay Main '
Lay Lateral-for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water 1�r Well
Proposed Start Date ,7�'/r Estimated time for completion 3- 1s
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 �c�J► the holder of Drain
Layer's License No. 2y . 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: Lled d A:::z `a•6�7
Licensed Drain Layer
Date:__" /r
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc