HomeMy WebLinkAboutDrain Layers Permit 18 Wildlife Trail Permit No. 8036 Town of South Windsor, CT
Permit Date 03/16/2006 Drain Layer Permit
Expiration Date 04/15/2006
Descrip:
Applicant . '
Lk:ca on
Name FOLSOM CONSTRUCTION LLBt _RVI�y71�I,Tt UNIT 1
Addr. 138 RYE STREET
Owner
t
SOUTH WINDSOR C"E: g6�74
Phone No. (860)528-8'928
The Drain Layer assigned this peat -Yid$ ....a Cen:se issued by the
state and hereby agrees;t9' a71 Ehe terms -_ ncT condi01dns .set forth in the
attached 'Conditions' . ,A11 toYlc sh 12 b6 In et*�rt3ari .e wrtIl Town of South
Windsor standards, all :aSHAequtireen ;< attd-thc gt'tachd conditions.
Issued By ______ vow
Title:
Date Inspected Inspected B
----------------
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 8036 ConraC'Eort F.OLSOT�I' G.p�TSTRUCTION LLC
Location 2 A'ddre&s ;138 YE'$TREET
A . O
Type Work NEW SAN LAT _ s. uTH..WI14 SQR `�:T 06074
Phone No (.B.D)$28 8928
Date Insp Needed pate izb'
........ .: .. ,. .-.::,.::... r...,:k.
Time Ins NeededOt
p ------------- s—r imps k ?`
Inspected Bye ......
Work in Progress �{ ! . � s� $
Input :w �_ date
TOWN OF SOUTH WINDSOR
SANITARY. - SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET
SUBDIVISION:NORTH ARROW
ARROW
._ � 7
-- - �4
-
i � 1
_- _-;-
CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUP SOR (PRINT),-,
STREET ADDRE §S SIMATURE
f° Gr�.. ✓��- C DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER `
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
"FO
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: / / �,'�� L
of #
Street No.
Street Name -
Premises owned by:
Name of Firm:
-Phone: -5 Z S'F��
Address.of Firm.
TYPE OF WORK:
Lay House Drain Lay Main Repair House Drain
-
Lay:Lateral for Commercial/Industrial -
Building of
acres
Connection will be made with -
EAsting Water Supply: Public Water__ Well
Proposed Start Date If Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARD
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT S,
Permit-is to be issued to the h
Layer's license No. �r�� older of Drain
will be issued.a 6�--• Only.holders of P-1, P-7 or W-9 licenses
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.
Town Street Excavation Permit No. Applicant has received
and/or ConnDOT Permit No.
--------------
-CBYD No.
Signed: Print Name:
Licensed Drain Layer
Date: lam'
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc