HomeMy WebLinkAboutDrain Layers Permit 161 Cornerstone Driv 800017 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 05/07/08 y;
GIS ID: 23800161
.+< ` FEE: 60.00
MUNIS APPLICATION# 200800615 `` EXPIRATIO
N DATE: 06/06/08
APPLICANT
<.LOCATION
NAME: EAGLE EARTHWORK :ERV `"
AT�TSS` ' Y' 1: ORNERSTONE DR
ADDRESS: 101 N MOUNTAIN ROAD
ETA CHR.STOPHER J
CANTON,CT 06019
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84�` iNERSTONE DRIVE
U-�H WINDSOR CT 06074
PHONE -
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860 6 -2 93 � ?:
W
ORK DESCRIPTION
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YER ASSIGNED TO THIS,��RMIT��A�t�� ;��;.`� �:.'I� ��.:�..� �E�)`���:f'T'Hi�S;T&E AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORThINA<.,: '141TAGF 1 t N.S'.> W SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDAR'I S A t CIA` .- 5.: 15 I. f ACHED CONDITIONS.
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: '% ove l? CONTRACTOR:
LOCATION:__
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: tab
WORK IN
PROGRESS: Q--5t lr"r Z sfi3O<-d 6 P✓c
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INPUT: DATE:_
W/2007 Town of South Windsor INPSECTION REPORT 07
Pe rr►► 4-4 $'00017
APPLICATION,FOR DRAIN LAYER PERMIT
cZrP/ aoo 8 oa6/5 TOWN OF SOUTH WINDSOR
" PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: 16I 6rVk1
f4w, Df, Lot # _
Street No. Street Name
Premises owned by: &A Ator AizAer�
Name of Firm: ea 4 Phone: -69 4W2
Address of Firm: f"®/
TYPE OF WORK:
Lay House Drain X ; Repair House Drain ;
Lay Main 6y Lateral for Commercial/Industrial
Building of acres
Connection will be made with PL)c
Existing Water Supply: Public Water Well
Proposed Start Date - 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 Af t6 ad 11,;&X 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: Al. IV14 - 1� Print Name:
_ _ C6/0,� IetJ c°ai�
Licensed Drain Layer
Date:
Standard:Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: '"
BUILDING ADDRESS
STREET . n4 e s e P `
SUBDIVISION:
cAec i, IL
NORTH ARROW
FT 7
71
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p--SAC
CO TRA R (PRINT) NAAE OF CONTRACTOR'S SUPERVISOR (PRINT)
SMEET,AADD�RESS G� SbAtURE /
DATE
TOW STATE ZIP INSPECTED BY TOWN
CJ� I DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER