HomeMy WebLinkAboutDrain Layers Permit 75 Murray Road 800058 TOWN OF SOUTH WINDSOR,
PERMIT NUMBER R, C T
DRAIN LAYER PERMIT
DATE: 10/28/08
GIS ID: 61800075
MUNIS APPLICATION /a
# 200801686 s«<' FEE: 60.00
EXPIRATION
ION DATE:
J 8
APPLICANT; r
NAME: SKIPS SEPTIC LOCATION
a
ADDRESS: 27 MUDDY BROO .` 1 {.;r'., .>. ADDRL 75 MUiRAY ROAD
I IAD5 fivTEWART MOLLINA
ELLINGTON,CT 0602 £ ..
V MiJR. Y ROAD
PHONE WINDSOR,CT 06074
860-8'7�=2332£
WORK DESCRIPTION: NEWMU
THE DRAIN LAYER ASSIGNED TO THY$PE1�VI T 1 P,S� r•,. 'A `"' � fi " a
THE TERMS AND CONDITIONS SET FOhj4:W>iA-V,ATE E. TSSIII °B14`,TITIFxSTATE AND HEREBY AGREES TO ALL
THE TOWN OF SOUTH WINDSOR STAND 4;RD t I ;gS IO I"� ttLlx V 6RK SHALL BE IN ACCORDANCE WITH
: l? E ATTACHED CONDITIONS.
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ISSUED BY DA E INSPECTED
10/28/2008 3:47 PM INSPECTED BY
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: bd CONTRACTOR:
LOCATION:
TYPE OF WORK:
--:_— ..DATE INSP NEEDED: J
DATE INSP: /f /z/�8
INSPECTED BY:
WORK IN
PROGRESS:--(. -raccd�✓ .'L.� � (r� rUG sbje
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AS-BUILT: Cf
INPUT: DATE:
W/2007 Town of South Windsor INPSEMON REPORT 07
Perm,', ` �OGaS g
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: 7 S "R 2&x' jZ Lot #
Street No. Street Name
Premises owned by: M a 4-fIV R SST£ 2 -r-
Name of Firm: sK(P57 s FP1-? C_ Phone: S z 3 3 2-
Address of Firm: 0 - 00)( 4_1 N 67D
TYPE OF WORK:
Lay House Drain ; Repair House Drain
Lay Main _; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with W/ 4 Sa/z 3 r VC_
Existing Water Supply: Public Water y\ Well
Proposed Start Date TZ9'7) 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 -7"O-M lW RqLl-'-E iz, the holder of Drain
Layer's License No. ao 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 attached thereto. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No. 00 2�74-8
Signed: �eL. Print Name: eS GU&ICg'
L censed Drain Layer
Date: /0 2 OSS
standard ForMs\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc : .
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