HomeMy WebLinkAbout192 Graham Road Sectric# APPLICATION FOR BUILDING PERMIT
Plumbing# 192 Graham Road
WAC # Date: - -
Sprinkler# No. 28128
FINAL - ,
Buildir geo p Estimated Cost $
�nAer COMPLETE RED BOXED AREAS Permit Fee ,
Affidavit TYPE OR PRINT ONLY - Occupancy Fee
Appr.for C01-P e e SIGN ON REVERSE SIDE
Total Fee $
TO Bls ,TO SOUTH WINI)SOR,CT (Additional Cost) $
The undersigned hereby applies to do work according to the following specifications:
Job Location 15r2 nc. Lot No. Sim
of Street Zone
Applicant b Tel
s # Q
s Addre n
Zip Lic#
Owne Address .�• ,���,,� �.
Architect
Address
Sq. Ft.New Area: 1st FL 2nd Fl. 3rd Fl. Total New Area
#Rooms #Lavatories #Bathrooms #Garages.
Purpose of this permit: /
J
City Water 0 Well ' Septic System ❑ Sewer k?
Ins. H.O. V S.P._ Cert._ Area Basement
Approved by Date -d Garage
Use Group Construction Type
Rowed 1/97
I hereby agree to conform to all the requirements of e L ws of the State of Connecticut and the Ordinances of the Town of
South Windsor and to notify the Building Inspector any tion in the tans or specifications of the Building for which this
permit is asked,and agree that this building is to I t pro r d" tance from all street lines,side yard lines,and required
distances from all other zones and is located in is ing nd's se is alWwed.
Signed
I hereby apply for a Certificate of Oc the o ribed in this application for the permit.
Signed
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
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**-28128-B 4,000
B10 FINAL 10/08/02 JFF A TEST HOLE DUG
B10 FINAL 10/09/02 JFF A CLOSED OUT.