HomeMy WebLinkAboutdrain layer permit 25 Gerber R 900041 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 06/29/09
GIS ID: 35110025 may, Y FEE: 60.00
MUNIS APPLICATION# 200900734 r" 8 y ! EXPIRATION DATE: 07/29/09
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APPLICAN ":LOCATION
NAME: ASHE CONSTRUCTI,)ML t. $'GERB R ROAD EAST CLUB HOUSE
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x THE �I RO REALTY GROUP
ADDRESS: 17 GRAMAR AVEWA'E,,F,.;` k C
PROSPECT,CT 0671<2'...�` £' . .< r, ., :. ECUT�VE DRIVE
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THIS :> H' . AN, . ' ���U��:13�:' .�a .STATE AND HEREBY AGREES TO ALL
THE DRAIN LAYER ASSIGNED TO BRIT. .�t�Y '�
THE TERMS AND CONDITIONS SET FORTE.,II `TIE,A] TCHhTIQ '."FAIL t�V,C)tK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDAiNS AI,*,;6 Ti4. C T 1k3`I S,Q IDTHl ATTACHED CONDITIONS.
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ISSUED BY DAT]EhMPIECTED INSPECTED BY
6/29/2009 2:09 PM °
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: RO 0 c// CONTRACTOR: A S he C
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TYPE OF WORK: Uec.J
--DATE INSP NEEDED: DATE INSP:
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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:-2-S �g {2� S'� Lot # B�"E_
Street No." Street Name
Premises owned by: AETP-b C3VJ
Name of Firm: E CWU�TJLTI0+�1 Phone: �0 ~ �s� -qSC�
Address of Firm: CW:5m C�t`�0--)
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with sbrL
Existing Water Supply: Public Water V Well
Proposed Start Date Estimated time for completion lzs 0
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 k I I r C4 V-JM �) the holder of Drain
Layer's License No.XM. a 2`19` 1 -d, my 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. -2T1 b 4
Signed: Print Name:
Lic used Drain Layer
Date: � eZ
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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TOWN OF SOUTH ANDSOR
SANITARY SEWER LATERAL FIELD LOC ATION
DATE OF CONSTRUCTION: 9 LJ
BUILDING ADDRESS ` �` �`-��
STREET" s
SUBDIVISION: l'.r'_ S�
NORTH ARROW Q 5m
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CONTACTOR (PRINT) NAM OF C C R'.S SUPERVISOR (PRINT)
STRtft ADDRESS SftTUkE
9' DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING .ENGINEER / DEVELOPER