HomeMy WebLinkAboutDrain Layers Permit 442 Pleasant Valley TOWN •OF SOUTH WINDS
OR,,
NUMBER O R, CT
DRAIN LAYER PERMIT
DATE: 07/22/08
GIS ID: 72900442
MUNIS APPLICATION# 200801105
FEE:
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60.00
XPIRATION DATE: /21/08 APPLICANT
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NAME: &H SLATER C
LOCATION
ADDRESS: >:, `..::442IEASANT VALLEY ROAD
75 COMMERCE WAS' <''; > °'s `w. r y:r,
SOUTH WINDSOR, T{}F0 7 ; 3 ' $'' EI Wq�DWZIGHT HOMES LLC
PHONES9UTVINDSOR,CT 06074
860-528 5
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WORK DESCRIPTION: NEW SE
NEW
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THE DRAIN LAYER ASSIGNED TO k F>> Nal"
THE TERMS AND THIS"?ERI�1I1� I1 ' X Ep 4CONDITIONS SET FORTH (j t` a�:• >Y T *STATE AND HEREBY AGREES TO ALL
' CN k. < ,L IWORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDAS, L
• TWA NATTACHED CONDITIONS.
ISSUED BY
DATE INSPECTED
7/22/200811:13 AM ' INSPECTED BY
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR:
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: o
INSPECTED BY:_
WORK IN
PROGRESS: l'a��r :fir ram, l/P� ''puc SDR 3 S
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AS-BUILT:
INPUT: &�_ DATE:
W/2007 Town of South Windsor INPSECRON REPORT 07
40leo-03.6
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
a pfl 4 , r PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: �'tl2 f 66� Lot #
Street No. Street Name
Premises owned by: /
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Name of Firm: Phone: SZ
Address of firm: -7S (,y1 ` .Ce G&v
TYPE OF WORK:
Lay House Drain_; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water._ Well
Proposed Start Date Z3 d Estimated time for completion 2 11405
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. 2 .. 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 thereto. Applicant has received
Town Street Excavation Permit No. �fached
and/or ConnDOT Permit No.
CBYD No.
Signed: Print Name: �!-
Licensed Drain Layer
Date: 2
Stamard F:bm1 Permft\APPLICATION FOR DRAIN LAYERS PERMrr.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: _ :2 3 "
BUILDING ADDRESS
STREET
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NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S UPERVISOR (PRINT)
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STREET ADDRESS SIGNATURE
S. tai JU Y 0[ Q Y ,/ {, 1 .ar ]/ ,q DATE
TOWN STATE ZIP INSPECTED BY TOWN
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TELEPHONE NUMBER
WHITE TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER