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HomeMy WebLinkAboutDrain Layers Permit 40 Wildlife Trail Permit No. 8038 Permit Date 03/16/2006 Town of South Windsor, CT Expiration Date 04/15/2006 Drain Layer Permit Descrip: Applicant Loe;ation Name FOLSOM CONSTRUCT.T"ON LLC a ? � kIF7ERWAtK Addr. 138 RYE STREET UlilIT ;.10 ..... 1. SOUTH WINDSOR - G� 060"7 ' Phone No. (860)528 892g: The Dr ain a'in L a Yr e`: s as `i` d t i. s state an d.:.:l' ceh�e.. s u d hereby a' i'e' ''s">o as...,`? >:::: :.... s ed by the - to 1 the teems aizd coniit]ci s: set fQ th in the attached 'Conditions' . All Wox ::shall 1? }Yetort3 .ne k3 Town of South Windsor standards all'OSHA:..re uize � th tsF the -attached3 conditions. Issued By ------------------ Date Inspected B I TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No " ContxaCtor .$pLSOM CQNSTRUCTION LLC Location '=4 19 Adds .S,Z.�2'EFT Type Work NEW SAN LAT SOUTH 'WINDSOR. CZ. 06074 Phone .Ncr' 5.8 )528 8'928 Date Insp Needed ------------- D&1: Time Insp Needed ------------- Timers � J Inspected By �v , Work in Progress t ,J_viv'ritirw��_1i✓_�_`�--�f—�—f0"c� ,�,(o►�,�_ 1��� p.� " ��� --���'` PA-- Sufi ^� - ---- Input Date TOWN • OF SOUTH WINDSOR SANITARY . SEWER. LATERTIELD ,CA�L LOCATION DATE OF CONSTRUCTION: "© BUILDING ADDRESS STREET SUBDIVISION: wee NORTH ARROW A / i/ i •-� I �i.7 Cr � Yir ✓O. ce l CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUP SOR (PRINT) eve- STREET ADDRESS SI TURE / TOWN STATE ZIP INSPECTED BY TOWN DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER 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: ,e Street No. Street Name - Premises owned by: Name of Finn: Phone: S Address.of Firm: TYPE OF WORK: Lay House Drain X -; Repair House Drain Lay Main ' y Lateral-for Commercial/Industrial Building of acres Connection will be made with Existing Water Supply: Public Water_ Well Proposed Start Date '�-� Estimated time for completion ��5 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. 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