HomeMy WebLinkAboutDrain Layers Permit 22 Balsam Fir Road (2) 900012 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
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DATE: 04/09/09
GIS ID:07159999 �°"`f: . �' E `" '° • `%i
MUNIS APPLICATION# 200900315 '.``' l'r °' ': a ' "-0 FEE: 60.00
EXPIRATION DATE: 05/09/09
APPLICA ,..:` °...`..`::. ''-; LOCATION
NAME: EAGLE EARTHWOIz Rt .> 1- B�.LS'1M FIR ROAD
ADDRESS: 101 N MOUNTAIN RO CV4 SOUTH WINDSOR
CANTON CT »<�r7,,. s
0601 1 0 SUL, IVAN AVE
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VIS{JR CT 060742734
PHONE r ,
860-69 202
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WORK DESCRIPTION: NEW S
THE DRAIN LAYER ASSIGNED TO THIS$EIfT A1rBSjF �i6''I3F STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORT &—w.my C RK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDAI irQ s;fk : 58 A.ND 1 I ATTACHED CONDITIONS.
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ISSUED BY DATE_ INSPECTED INSPECTED BY
4/9/2009 3:22 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: R C)Uo a CONTRACTOR: F.0 li 4 �o
LOCATION:_ .
TYPE OF WORK: Vl w� Cor r�
-DATE INSP NEEDED: DATE INSP: oQ
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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: 12__ &g 1_15 .it f `�') -&ot #
Street No. Street Name
Premises owned by: lL c,l2 /'o`er O �7v1i y�f
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Name of Firm: JeaQr4-4 WC7e k Phone:
Address of Firm: k4 elk, C_CC�Arll
TYPE OF WORK:
Lay House Drain_; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with Ip
Existing Water Supply: Public Water VV 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 .��i b/+r the holder of Drain
Layer's License No. �7g b . 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. 0 61 6 1 r'
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Y Signed: P '_ %� � Print Name:—_AGk�d
Licensed Drain Layer
Date:
Standard:Forms\Permits\APPUCATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF 'SOUTK WINDSOR
SANITARY SEWER LATERAL - FIELD LOCATION
DATE OF. CONSTRUCTION:
BUILDING ADDRESS :STREET S
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CONTRAC R '(PRINT) NA F CO C R'S S PERVISOR (PRINT)
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STREET ADDRESS 1 NATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER -
WHITE = TOWN PINK CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER