HomeMy WebLinkAboutDrain Layers Permit 11 Wildlilfe Trail Permit No. 8035
Permit Date 03/16/2006 Town of South Windsor, CT
Expiration Date 04/15/2006 Drain Layer Permit
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Applicant
I'M t*t iOn
Name FOLSOM CONSTRUCTION LLC:_
iddr IF7ERWALIC UN'TT '18
Addr. 138 RYE STREET
SOUTH WINDSOR CT 0 07 '
Phone No. (860)528-8*9
The Drain Layer assigngd :thi permit h$s a valid
state and hereby agre.s tb ail ��ne issued by the
attached 'Conditions' . Al1 wo tie Gems' �xdyond�tos 5t forth in the
1.•shall .b ' ac4xdtic_� w:stli Town of South
Windsor standards, ±all 'OSHA requirement�x and the- attached. conditions.
Issued B
— t _ ------------------
Date Inspected
--------------------::..:.:.. TrYspected B ,
TOWN OF SOUTH WINDSOR JaSPECTION REPORT
Permit No. 8035
Contractor -.FQLSOM O'O BTRUCTION LLC
Location
AddYeSs Type Work NEW SAN LAT
S UTLS WINdSS1QR. CT 06074
Phone Na �s�4���2e s92a
s�
Date Insp Needed
gate "
Time Insp Needed
Inspected By r 1
Work in Progress _ =nTd
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Input _ ----:<:Date
� TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION-
BUILDING ADDRESS : /
STREET
SUBDIVISION:
NORTH ARROW
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45
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUP SOR (PRINT).
Ige
STREET ADDRESS S16NATURE
-at.." DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
J033
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, Cr.
FEE $60.00
Location of proposed work: // GC/i���7ZC 741,� j; ��of #
Street No. Street Name
Premises owned by:
Name of Firm: IGo Cc
Phone: Z ��
Address.of Firm: /Y 07 Ave-
TYPE OF WORK:
Lay House Drain Repair House Drain •
Lay Main - • Lay-Lateral-for Commercial/Industrial
Building of acres
Connection will be made with_ ,J'02 •, _
Existing Water Supply: Public Water `� Well
Proposed Start Date_1_—_6 Estimated time for completion
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 /:&e!�qrlor-7
Layer's License No. _ 2-6 S¢G the holder of Drain
will be issued,a 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
an ConnDOT Permit No.
CBYD No.
Signed: Print Name:
Licensed Drain Layer
Date:_ 3—lC�
Standard Forms\PermikAAPPLIMION FOR DRAIN LAYERS PERMIT.doc