HomeMy WebLinkAboutdrain layer permit 253 Gerber Road East 900038 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE:
GIS ID: 35110025 ' =
, vt ' FEE: 60.00
MUNIS APPLICATION# 200900732 ;, EXPIRATION DATE: 07/29/09
APPLICANT
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NAME: ASHE CONSTRUCTIQN I L( : � k �RES . . 25 GERBR ROAD EAST UNIT 3
ADDRESS: 17 GRAMAR AVENi jE F;*;,.. 0 TH METRO REALTY GROUP
PROSPECT,CT 0671 4 t XECUTIVE DRIVE
PHONE �II Pi I00
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WORK DESCRIPTION: NEW
RIPTIO SE �^ r .. :
THE DRAIN . ,
LAYER ASSIGNED TO THIS PFRII3T,.Ik1 A U ;' :` S'SIJk:BI 7IE: TATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTI�':IN T DRK SHALL BE IN ACCORDANCE WITH
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THE TOWN OF SOUTH WINDSOR STANDARIS A :pSIA I EjjS;.. .II3;TI3I ATTACHED CONDITIONS.
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ISSUED BY DATE SPECTED INSPECTED BY
6/29/2009 12:28 PM
TOWN OF SOUTH WINDSOR INSPEMON REPORT
PERMIT NO.: fXb3____r__ CONTRACTOR:_ the Cons
LOCATION:.�,�
TYPE OF WORK: 11 e� dew su Cc� }-,tee_
-- .: --DATE INSP NEEDED:
DATE INSP:_ 1
INSPECTED BY: 60
WORK IN
PROGRESS:
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DATE: 1 I
W/2007 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:_15 (oe;'Zgf�i2 F-P . EASE Lot # I�LD #3
Street No. Street Name
Premises owned by: V o OmMUt-I`�bN
Name of Firm: As 4F Coosrk o lo/\3 Phone:
Address of Firm: 1
TYPE OF WORK:
Lay House Drain ; Repair House Drain
Lay Main SOU,; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water Y Well
Proposed Start Date7jtp I OqEstimated time for completion 23
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 A�rge OC-I�JS1MU1 the holder of Drain
Layer's License No.RM.0217117711- 0 7. 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. 2gD1U(Pd
Signed:'��In Print Name:
Licensed Drain Layer
Date:
Standard Forms\Permits\APPUCATION FOR DRAIN LAYERS PERMIT.doc0
TOWN OF SOUTH ANDSOR
SANITARY - SEWER LATERAL FIELD LOCATION
DATE. OF CONSTRUCTION:
BUILDING ADDRESS _&14plala ' #3
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SUBDIVISION: 4ILL SMEPrb
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CONTRACTOR (PRINT) NAME OF CONT 0 '.S SUPERVISOR (PRINT)
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TdWNT STATE ZIP INSPECTED BY TOWN
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LEFH-dNE NUMBER
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