HomeMy WebLinkAboutDrain Layers Permit 64 Frazer Fir Road 800057 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
K
s m DRAIN LAYER PERMIT
DATE: 10/28/08 {
GIS ID:34430064
.ry; '. FEE:
60.00MUMS APPLICATION# 20080167
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NAME: EAGLE EART ';.LOCATION
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ADDRESS: 101 N MOUNTAIN t�':b r � ` ' F�ER FIR ROAD 8
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CANTON,CT 06019` y .:. . ,. mAN AIJ-NO BUILDERS INC
{3V"lam k-t�PIEL RD UNIT 3—F
PHONE 860-693y2tI27 H WINDSOR,CT 06074
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WORK DESCRIPTION: INSTALL SANIT EVER LAII2AT
THE DRAIN LAYER ASSIGNED TO THIS FERMIT FIAI,A��II STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORT II4'1"IIE t�'I''�z�G1�E �� IT��:.. �,Ls�ORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDAI S,All O` I lMQ�E-' A ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
10/28/2008 9:55 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:-- CONTRACTOR:
LOCATION: (n f 1?-7 17. r)
TYPE OF WORK:
-=_--_-= DATE INSP NEEDED: DATE INSP:
INSPECTED BY: A t>
WORK IN
PROGRESS:
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INPUT: DATE:
W/2007 Town of South Windsor INPSEMON REPORT 07
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:_ Qr'�1Z•`e-!" r`� RPLot #
Street No.
Street Name
Premises owned by:—*G;h n r 12 ydG)�6(?
Name of Firm: q r'E E adA Work S PfV,CM Phone: '90 3,c)-W7
Address of Firm: /V® rf4 /I/.
TYPE OF WORK:
Lay House Drain_; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
rr Poe,Connection will be made with /D
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 the holder of Drain
'Layers License No. �6
. ��1 . 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 theterms
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.
Signed Print Name: l ri A _ems
Licensed Drain Layer
Date:
Standard-Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc -
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