HomeMy WebLinkAboutDrain Layers Permit 72 Frazer Fir Road 800056
PERMITNZMBER TOWN OF SOUTH WINDSOR, CT
DATE:'10/28/08 ^., 5,. .,,:: DRAIN LAYER PERMIT
GIS ID:34430072 x, >
MUNIS APPLIC200801678
ATION# 2008 01678 >;
FEE:
RAT IO�:� N DA
TE:TE•
APPLICANT x ; 60.00
lI/27/o8
NAME: EAGLE EARTHWOj5E S RV �,LOCATION
ADDRESS: 101 N MOUNTAIN O FR
RES 72AZR FIR ROAD
CANTON,CT 06019 � ' `MtNNAIZTNO BUILDERS INC
SCHAP
0 b,, a , �> L ROAD
86
PHONE -6934,202 w VTTF`
WORK DESCRIPTION: A f
INSTALL.
THE DRAIN LAYE ::... :.
R ASSIGNED TO THIS'I�E "�T °J�•''' "� , ...'Fi. ;
THE TERMS AND CONDITION A V .5'SUI
S SET FORTI�IKT..: IAGH. •• AND HEREBY AGREES TO ALL
THE TOWN OF SOUTH WINDSOR STANDARDS 4 I p ` ��T�OAL (1tK SHALL BE IN ACCORDANCE WITH
4 t I BM AND 'ATTACHED CONDITIONS.
ISSUED BY
DATE INSPECTED
ioizsizoos 9:444 AM INSPECTED BY
1
TOWN OF SOUTH WINDSOR INSPECTION REPORT
`
PERMIT NO.: CONTRACTOR: A- 0611
v
LOCATION:_ r'a � ;e 2-
TYPE OF WORK:_
-DATE INSP NEEDED: DATE INSP: l ylel lay
INSPECTED BY:
WORK IN
PROGRESS: CO:, }�, �s kad G' "I've
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AS-BUILT: - --
INPUT: DATE:_
W/2007 Town of South Windsor INPSECTION REPORT 07
r ZaaBajg7B
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL F
1540 SULLIVAN AVENUE ,
SOUTH WINDSOR, CT
FEE $60.00
7C -
Location of proposed work: �(��. T r Lot #
Street No. Street Name
Premises owned by:. f a Rn � rih 0 yc'I d ee-S'
Name of Firm: ej 4 le E,�4� 00rk> 5 ftiCe� Phone: ?G0 6g3_ad;
Address of Firm: j0Z
TYPE OF WORK:
j Lay House Drain ; Repair House Drain ;
Lay Main; Lay Lateral for Commercial/Industrial
Building - of acres
Connection will be made with PV�
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 "L i C'& 1 0116-10T the holder of Drain
Layer's License No. -2-7 . 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.
I
CBYD No.
i Signed: Print Name: 1 �1 Co—
Licensed Drain Layer
Date:
Standard FormAPermits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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