HomeMy WebLinkAboutDrain Layers Permit 28 Brightman Circle (2) 800047 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 08/22/08h°°
GIS ID: 13900028
FEE: 60.00
MUNIS APPLICATION# 200801303 EXPIRATION DATE: 09/21/08
APPLICANT LOCATION
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NAME: J&H SLATER CON�T GQ DR $BRIG ITMAN CIRCLE
ADDRESS: 75 COMMERCE WAS, �' R I{ LCO INC
SOUTH WINDSOR,,'A"'
t3 xrr � 4 ELI i1GTON RD
s xIT INDSOR,CT 06074
PHONE
860-529-5252
WORK DESCRIPTION: INSTALL ANIT'A�2:'SEA' T ATRAT
• cTa:x
TH
E DRAI
N LAYE
R ASSIGNED TO THIS'=PE11IT'HtS A:i(jTi. ISS .< , •` is
,, � BY, TATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH IiI'T$ES T IA�IX bQ. I1R1IsS" ALA WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDA S AFL C HA.1.'EQ.0 ITSw,AN 7 E ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
8/22/2008 9:20 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: z CONTRACTOR:_. _S
LOCATION:_
TYPE OF WORK:_-- S w r1 r
-DATE INSP NEEDED: DATE INSP: RbS oV.
INSPECTED BY: 6b
WORK IN
PROGRESS:_ ��i���i�: . ,���,t�D (L Pvc SI2 Fro.., <�i_lll b +�
AS-BUILT:
INPUT: DATE: o
D
W/2007 Town of South Windsor INPSEMON REPORT 07
Apo.., +t $®t
APPLICATION FOR DRAIN LAYER PERMIT PcT S°°oc}1
` A. TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: Lot #_$
Street No. Street Name
Premises owned by:
Name of Firm:_ Phone: Z
Address of Firm:77�_
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 k. _ Well
Proposed Start Date*_L�
LCA
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 �J o the holder of Drain
Layer's License No. Zo 4 Only holders of P-1, P-7 or W79 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 an ttached thereto. Applicant has received
Town Street Excavation Permit No. Ad and/or ConnDOT Permit No.
CBYD N
Signed: - - Print Name: d/ e/.�
Licensed Drain Layer
_Date:
: : standard:Forms\PermitS\APPUCATION FOR DRAIN LAYERS PERMIT.doc
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