HomeMy WebLinkAboutDrain Layers Permit 177 Rye Street (2) 800055 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
« DRAIN LAYER PERMIT
DATE: 10/16/08 ,
GIS ID: 78600177
^:`n. FEE:APPLICATION# 200801622
60.00
r u
EXPIRATION DATE: 11/15/08
APPLICANT
NAME: J&H SLATER CON C- .,. LOCATION
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ADDRESS: 75 COMMERCE WAI' '''£ f y4 I7 RYE' TREET
E ALI) 3NC'.(CONNECTICUT)
SOUTH WINDSOR,Cl ,r
t7;B0x 699
PHONE 4£ TH NDSOP,CT 060740699
860-
s28sz�2 J
WORK DESCRIPTION: REMOVE AIDIi C
FOR JOB yI' ILR'1 P3ALT `. ::....
TH
E DR
AIN
LAYER AY
ASSIGNED TO THIS 1' RI7 I , ALI 'SUM ISY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTk Ili THE z1 "3 AC I s Q I Tfi�N � OEAND RK SHALL BE INATERACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDAR I,S'`AI pSI AV26",. •RE �.T. tkND`.1 ATTACHED CONDITIONS.
ISSUED BY
DA E INSPECTED P CTED BY
10/16/2008 2:44 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 8 �005!r, CONTRACTOR: LATFez
LOCATION:
_ 112. Si, - �SuJ Ji rrs
TYPE OF WORK:_` )�c�NEsn,r��.
DATE iNSP NEEDED:
DATE INSP: )n 4 08
INSPECTED BY: J J P
WORK IN
PROGRESS: YAf-,J�
c:DivtiJ+L�T`l�^� Z� lQ�.tJ' cor�S GTlN a ��.el�rv-S
AS-BUILT: /
INPUT: DATE: 0 ��
W/2007 Town of South Windsor INPSECTION REPORT 07
49PL, ' 2®Q58c>1 (2Z pF- 'T # bOoc�S�S
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: G-11 Z( 4f"
SC Lot #
Street No. Street Name
Premises owned by:
Name of Firm: �VYL Phone:
Address of Firm: 7
TYPE OF WORK: �44.ddt_-
Lay House Drain______; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
_/J/�
Existing,Water Supply: Public Water-Ii/W Well
Proposed Start Date �(� ( Estimated #ar comple i r ..r�r
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 I(W Sthe 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. !2LI ILt ? and/or ConnDOT Permit No.
CBYD No.
Signed: Print Name:
Lice sed Drain Layer
Date:
stat)d6rd:Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: __10 Zo 18
BUILDING ADDRESS
STREET `(
SUBDIVISION: Au I
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S.EW� ,➢�..5 Co�a�CT"
NORTH ARROW
—74
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
25 C am m ouc- wlgl 0 hn 16 I v 9
STREET ADDRESS SIGNA RE
S o� W 1�95 t"XL cl- A,,,, DATE
TOWN STATE ZIP INSPECT TOWN I u 12�0 Vg
(`66� 5Ly-�- i5 � DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER