HomeMy WebLinkAboutdrain layer permit 15 Good Hill Road 900058
PERMIT NUMBER TOWN OF SOUTH W I N D S O R
CT
,..7.; DRAIN LAYER PERMIT
DATE: 09/28/09 rv.
GIS ..-
ID: 36000015 "e
MUNIS APPLI ;i. ".
CATION# 200 t r
901175 %, FEE: 60.00
EXPI RATIO ND
P
1
lia
28/09
A CA
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NAME:
JAMES THR - L owE D. OCATI
ADDRESS D
RIVERSIDE DRI S GOOD HILL ROAD
VERNON ROCKVILL §6 y" y �1BR iP 3AL PLUMBING CO INC
64 SULLXVAN AVENUE
PHONE 860-289-0095 r r +� k O T T l"SOR,CT 06074
WORK DESCRIPTION: NEW SE'� .��'�IONfr
+•^' �Pk,,.;.).::. k.. .:. :rind.+:�v
E DRAIN LAYER `��•. :;. '� ;;, �:.. sf�.:;�,'' ,, `�3;
ASSIGNED TO THIS`�'E. �' .I ?�t ;v:-�.'.::< �" ,•y`.�':�`J+ <_;.
THE TERMS AND CONDITIONS SET STA
.,.
FOR :• AG ..l f TE AND HEREBY AGREES TO ALL
THE TOWN OF SOUTH WINDSOR STANDARY3,S FYI vSAI'Ifi �AND'THE ATTACHED CONDITIONS.
Rr
ALA WORK SHALL BE IN ACCORDANCE WITH
ISSUED BY N ®f
9/28/2009 10:20 AM DATE INSPECTED INSPECTED BY
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 0 00 S e CONTRACTOR: V Av,) 5
LOCATION: IS- 6;®od A I I/ goad
TYPE OF WORK: A)ecj Sewer_
DATE INSP NEEDED: DATE INSP: V 2q
INSPECTED BY: n
WORK IN
PROGRESS: " «1y pyc S iJ2
5 i:t b To tr✓�r�l at �b�^xR- w i �t� rs7 � C,
3/4i , Ce4.z orj
SEPTIC TANK `
S_ ez ` r, , WITNESSED �S ❑ NO
AS-BUILT: L7
INPUT: c 0\, DATE: 101
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: �� (n, 1
Lot
Street No. Street Name
Premises owned by: Q - 146 v GnS
Name of Firm: tic,,n<- � e+r 4, 1 Z Sro u.) Phone:di 6
Address of Firm: Ellv
TYPE OF WORK:
Lay House Drain u ; Repair House Drain ;
Lay Main---------; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with S 10 6R 3
Existing Water Supply: Public Water Well
Proposed Start Date ._ Estimated time for completion OT
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 t' � the holder of Drain
Layer's License No. 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.J&O,77 3 c 6 ,?55-�S
Signed: L. Print Name:
Licensed Drain Layer
Date:
Standard FOtms\PerM ts\APPUCA7ION FOR DRAIN LAYERS PERMrr.doc
TOWN OF SOUTH ANDSOR
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TOWN STATE ZIP INSPECTED BY TOWN
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TELEPHONE NUMBER
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