HomeMy WebLinkAboutStreet Excavation Permit 798 Main Street 800062 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 11/18/08
GIS ID: 54900798 FEE: 60.00
MUNIS APPLICATION# 200801826 EXPIRATION DATE: 12/18/08
APPLICANT LOCATION
XxxNAME: CASELLA CUSTOM BULT DO.. ADDRESS 798"MAIN STREET
ADDRESS: 2409 HEBRON AVENIJ�. OVER CAROM DAVID A&JO-ANN
P O BOX 775 $ V1AIN ST
GLASTONBURY,CT(Q§033 S{ UTa WINDSOR,CT 06074
PHONE
WORK DESCRIPTION: REPAIR CL bGG SEW;:
THE DRAIN LAYER ASSIGNED TO THIS PERMfT SAS V:- LIL LI-I I�SE TSSUEI7 BY THE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH ITT TFII �1TT�1' 1 FD O1 FTIONS ALL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARD$,ALT £JSHL�IECIRMLIITS;A1J TTIE'ATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED BY
1 1/1 8/2008 2:15 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 0(fin
. CONTRACT-OR:���C-�'
LOCATION: 7 cl `1cz i �j
TYPE OF WORK:_ )Zi
—= DATE INSP NEEDED: DATE INSP: o. 3/ `
INSPECTED BY: /?b
WORK IN
PROGRESS: 4
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DATE:_ !��U U,
W/2007 Town of South Windsor INPSEMON REPORT 07
/Oc?r"ail i `l �0-00 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:_ ��c� ��a rr� �T Lot #
Street No. Street Name
Premises owned by: l �(')E> '.yVycl-)
Name of Firm: ��zr'(; Phone:
Address of Firm:
TYPE OF WORK:
Lay House Drain ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with Xlly or c-)
Existing Water Supply: Public Water V' Well
Proposed Start Date_ Estimated time for completion /-2- J�
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 r� u �� the holder of Drain
Layer's License No. T L 1J - 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. �
Signed: 75 Print Name: �'�
icensed Drain Layer
Date: l / /`/A:4—
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: '� t
BUILDING ADDRESS
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SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF RA OR'S UPSOR—(PRINT)
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STREET ADDRESS SIGNATU
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TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER