HomeMy WebLinkAboutdrain layer permit 247 Deming Street 900024 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 05/19/09
GIS ID: 27600247 FEE: 00
MUNIS APPLICATION# 200900523 EXPIRATION DATE: 06/18/09
APPLICANT LOCATION
NAME: DOUBLE C CONSTP ICTION LLI ADDRESS 247 DEIVIING STREET
ADDRESS: P O BOX 785 W TER -AGLIAADO ANNA M
145 DIVIDEND ROAD
ROCKY HILL,CT 0
J
606747 DEMING STREET
JI,JTIVDSOR,CT 06074
PHONE
>:
WORK DESCRIPTION: LATERAL EXTIION TOT E� I
FOR 247 IJMIN Z P � IDPIN . DOWN PROJECT
THE DRAIN LAYER ASSIGNED TO THIS<PERI IIT'>H S _ :IT T. S�SLJED!)- TT1JE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORT I I }�H �Tt , "AIyT�WOAK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDAj7S,.,ALL' HA I T tANI I I TTACHED CONDITIONS.
ISSUED BY . DATE INSPECTED INSPECTED
5/19/2009 8:49 AM
TOWN OF SOUTH WINDSOR INSPECiTON REPORT
PERMIT NO.: '�.0 00 d y CONTRACTOR:
LOCATION:_ q
TYPE OF WORK: -
__.__._ . "DATE INSP NEEDED: DATE
INSPECTED BY: 8 D 0
WORK JN
PROGRESS: C o�c v �w s,��y.r j y ®y e s ore- 3 A f�®w
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INPUT: DATE:
W/2007 Town of South Windsor IKPSECIION REPORT 07
Perm, t 9aoa a`f
APPLICATION FOR DRAIN LAYER PERMIT
a�P/ aOogOo 5 TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: S 4 Lot #
Street No. 9treet Name
Premises owned by:
Name of Firm:Qpulyl- C Cons Phone:&�a 731-I c 3
t2oc,k lal �t
Address of Firm: i y 5 ()k v 1 d C
TYPE OF WORK:
Lay House Drain X ; Repair House Drain ;
Lay Main Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with Pv C-
Existing Water Supply: Public Water X 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 ()ea"' co t t`h C the holder of Drain
Layer's License No.QLm 02c IRS•&to 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. Aooq 9:00;L L1%
Signed: ozyvl" 6&610 Print Name:_0,2a n.
Licensed Drain Layer
Date: 5 - I&-o cic"iLm d/ i 6,� Pv j e.4
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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