HomeMy WebLinkAboutDrain Layers Permit 31 Balsam Fir Road 900003 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
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DATE: 02/23/09w,
GIS ID:07150031f
FEE:
MUNIS APPLICATION# 200900127 , # '' f,<"''`w'`:/ . Y'``' : ==-.'3": 'i `, ;, ' 60.00
` f. EXPIRATION DATE: 03/25/09
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NAME: MANNARINO BUIL° BAL SA FIR ROAD
ADDRESS: 400 CHAPEL ROAD
UNIT 3F . r Ma NO BUILDERS INC
s ` 6 ,9 ELII�TGTON RD
SOUTH WINDSOR,£ 'fi167?#�f '
r ] ViNDSOR CT 06074
PHONE 860-28%.- �:"�� ,.01
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WORK DESCRIPTION: NEW SE)MO ON.
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THE DRAIN LAYER ASSIGNED TO THISEIT A e
. SSI,�.��'B ':T T (STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTF_fI, IE`P1C` ,_. - Ijp SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARI (j AND THE ATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED BY
2/23/2009 3:14 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: Cf 3 CONTRACTOR: 'VlAa yj na r
LOCATION: 3 1 ,
TYPE OF WORK:_
-_-_-__- -DATE INSP NEEDED: DATE INSP:
INSPECTED BY:-t
WORK IN
PROGRESS:
AS-BUILT:
INPUT: DATE:--- �- q O
W/2007 Town of South Windsor INPSECTION 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:.31 8*1 S9,4 F'r P ip, Lot # _
Street No. Street Name
Premises owned by: I-QI 1W RV,'ldCmr
Name of Firm:_ 1�q Q/e F-*rAtU X k 5erV1'C-1et Phone: 00'-wIq 3` 7*7
Address of Firm:_01 00a'P-A /_ lk R.D. :C, 4*', c � a4r,01
TYPE OF WORK:
Lay House Drain ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
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Connection will be made with _ PVC.,
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—At Ai ke biI {God( the holder of Drain
Layer's License No. J-7f f 16 . 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:A1,4Print Name: rG��G
Licensed Drain" Layer
Standard Forms\Permits\APRLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
-SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION.
BUILDING ADDRESS
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CONTRACTOR (PRINT) NAME fit} CONT. CTO S SUP RYegR (PRINT)
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STREET ADDRESS / SIGNATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN -
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TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER