HomeMy WebLinkAboutdrain layer permit 25 2 Gerber Road East 900037 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER „,
<..,. .,. ;.4 DRAIN LAYER PERMIT
DATE: 06/29/09
GIS ID: 35110025 k jr
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MUNIS 3
APPLICATION# 200 < € FEE: 60.00
900731
EXPIRATION DATE:
07/29/09
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APPLICAN
;LOCATION
NAME: ASHE CONSTRUCTIfJI >=L ::">:::<;p„' : • ...:>::`x
� a $�I,RB R ROAD EAST UNIT 2
DRESS: 17 GRAMAR AVE Ni �.: T MtlkO REALTY GROUP
PROSPECT,CT 06712 �.
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PHONE : ,, ' :E1I Pt.' 601
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THE DRAIN LAYER ASSIGNED TO THIS TXRIT HAnA`V g "'E: T
THE TERMS AND CONDITIONS SET FORTII. IV THE IT CH f� T 1 ATE AND HEREBY AGREES TO ALL
p. i WC31tK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARI S�qL ;QS T (�} { J Nb;l ATTACHED CONDITIONS.
ISSUED BY DAT SPECTED INSPECTED BY
6/29/2009 12:16 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: Q3 7 CONTRACTOR:__
LOCATION:_ pr LQ(SI' uk) /
TYPE OF WORK: Yle,.J .Sc>Le r CD
.--_--:. .-. . ..DATE TNSP NEEDED:
DATE INSP:_ 7 ,9
INSPECTED BY: �p
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PROGRESS: r Frowt
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INPUT: DATE:
W12007 Town of South Windsor INPSEMON 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: AS-t— Lot # Z
Street No. Street Name
Premises owned by: (DNS(pJcm1\l
Name of Firm:: ASPIC comsl1 wo—(oo Phone: 59 .5IS0
Address of Firm:—IMW
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main 'GO ;Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with �3.5
Existing Water Supply: Public Water / Well
Proposed Start Date �w 4 Estimated time for completion-7123
/09
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 ASff—'-- 0WRi 6Aj the holder of Drain
Layer's License No. fLM , QZr1'1171-07 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. Q009 2 901(oto y
j�
Signed: Print Name:
Licensed Drain Layer
Date: lZq
Standard Forms\Permits\APPWCATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 7 121 b
BUILDING ADDRESS
STREET
SUBDIVISION: l
NORTH ARROW
7-LV1
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CONTRACTOR (PRINT) NAME OF CO C OR'S SUPERVISOR (PRINT)
IZ (zg�Ae- &Er
STREET ADDRESS SIGNATURE
7 DATE
TOWN STATE ZIP INSPECTED BY TOWN
263 � S C� DATE
NE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER