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HomeMy WebLinkAboutNew Sanitary Lat Street Cut Permits 232 800014 TOWN OF SOUTH WINDS PERMIT NUMBER O R, C T DRAIN LAYER PERMIT DATE: 64/21/08 GIS ID: 57900232 MUNIS APPLICA %TION# 200800504 FEE: 60.00 "' '' _ EXPIRATION V ON DATE: OS/21/08 03.. APPLICANT PP s.L I C A T:. NAME: x EAGLE EARTHWO .....:..:. ADDRESS: 101 N MOUNT .I. :: .•...,,,-k `''' 2 21 AS EL ROAD MOUNTAIN ISRES >'.. CANTON CT NA IV0 BUILDERS 060 INC f`�.. C AP L RD 3- F PH ONE U: W � �' I�TD S O R C - 6 07 86 .. 4 0 6 93- >::' WORK DESCRIPTION: NEW SEWT �It�" THE DRAIN ...,:;:.;:., .:..:.. ., .... LAYER ASSIGNED TO THIS I'FRM. ..... A' 5'• . THE TERMS AND CONDITIONS SET FORTS TTE AND HEREBY AGREES TO ALL IntTA ,,; :•.,;. ls\rS L1 ©RIB SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDAI�S � L t3��T� :. ;` ;:.�' � f TACHED CONDITIONS. ISSUED BY DATE INSPECTED INSPECTED BY 4/21/2008 3:43 PM 1 TOWN OF SOUTH WINDSOR INSPECTION REPORT a ' PERMIT NO.: 6I ' CONTRACTOR: LOCATION: TYPE OF WORK: DATE INSP NEEDED: DATE INSP: 2 316 S INSPECTED BY: WORK IN PROGRESS: 6e Jr P pc S D 2 3S from 54,L .4-v rror,} 0�- hek.sa- i s tiW i wo oSe`'JS tj ell SIC 14 qD w(1A h (e R {T cA AS-BUILT: INPUT: DATE: `'I I " 0j W/2007 Town of South Windsor INPSECTION REPORT 07 F000/4/ a�P/ aQpgooso APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, Cr FEE $60.00 Location of proposed Work: NSF Street No. Street Name Premises owned by: QriAwj � Name of Firm: Phone: ��1 Address.of Firm: 0441 'TYPE OF WORK: Lay House Drain Repair House Drain - . Lay Main . - . . Lay-Lateral'for Commercial/Industrial Building of acres cc Connection will be made with (�� Existing Water Supply: Public Water_ Well Proposed Start Date =d Estimated time for completion-off 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_ rt r Gl(i E � Layer's License No. _Z Z.�/!to the holder of Drain will be issued,a Only.holders of P-1, P-7 or W-9 licenses 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. Town Street Excavation Permit No. Applicant has received and/or ConnDOT Permit No. -CBYD No. Signed. Print Name: rC e l icensed Drain Layer cle Date:_ standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc T ' SOUTH WINDSOR SANITARY SEWER LATERAL - FIELD - LOCATION DATE OF CONSTRUCTION: - `" BUILDING ADDRESS Zo 4- STREET SUBDIVISION: NORTH ARROW .16 I aLIr CONTRACTOR (PRINT) tNAREC NT CTOR' SUP SOR (PRINT) 4 S EET ADDRESS S ace TOWN STATE ZIP INSPECTED BY TOWN DATE TELEPHONE NUMBER WHITE -- TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER