HomeMy WebLinkAboutDrain Layers Permit 85 Felt Road (4) 800043 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
r .»•. , DRAIN LAYER PERMIT
DATE: 08/19/08
GIS ID:32400085
MUNIS APPLIC ATION# 200 FEE:
60.00
' E XPI RA T IO DAT
E:E•
09/18/08
APPLICANT `
NAME: J&H SLATER CONST>GO j :LOCATION
ADDRESS: 75 COMMERCE WAY �' f �'` ��}DRE,S FELT GOAD
< G k I' RSEN LOIS H
SOUTH WINDSOR, T; b074� '
z40 DEMITG STREET
7C7 PHONE TH`WiNDSO CT 0
860-52 °5>
R, 6074
8�SZ5� :�..
WORK DESCRIPTION: INSTALL STI ` YEyRTE
THE DRAIN LAYER ASSIGNED TO THIS YRERRIT BIAS A�?�IHF1SSU BY STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTI*I,IN TIE A'�'TACHE;fr j AI I ;VVRK SHALL BE IN ACCORDANCE
THE TOWN OF SOUTH WINDSOR STANDARDS A.I L OS IREM3 S ANU`THE ATTACHED CONDITIONS. WITH
Q . .:...
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ISSUED BY DATE INSPECTED
8/19/2008 10:53 AM INSPECTED BY
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: C00— CONTRACTOR:
LOCATION: R
TYPE OF WORK:_ .1 n 11 Sa�n c�i ail-
-DATE INSP NEEDED: DATE INSP: 2® 03
INSPECTED BY: D
WORK IN
PROGRESS: 1����. ,; �s ��� r p VC sh w- H
---------------
AS-BUILT:_ �—
INPUT: C m DATE:_ \-
W/2007 Town of South Windsor INPSECTION REPORT 07
Awah��
APPLICATION FOR DRAIN LAYER PERMIT VEV.""r4V 60co43
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1 540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
�7✓ft
Location of proposed work:__ 85- ),a,- 5 6a y
Street No. Street Name
Premises owned by: ��Z�T/ail
Name of Firm: � �� L�l
- � Phone:
Address of Firm:
TYPE OF WORK:
Lay House Drain--; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with Pit,
Existing Water Supply: Public Water X Well
Proposed Start Date g Estimated time for completionf /�S
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 a Uj. 4416t the holder of Drain
Layer's License No. Z077-'10 . 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: t, JMWq5;:j
icensed Drain Layer
Date:
Stallard:Fomt\Permits\APPLICATION FOR DPJdN LAYERS PERMIT.doc
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