HomeMy WebLinkAboutdrain layer permit 83 Northview Drive 900057 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 09/28/09
GIS ID: 64500083 . ` " FEE: 60.00
MUNIS APPLICATION# 200901172 ' " y'� _'
r, f .; EXPIRATION DATE: 10/28/09
APPLICA �...::
k LOCATION
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NAME: ROTO ROOTER NORHVIEW DRIVE .
ADDRESS: 800 MARSHALL P Rl3VI4.ALBERT YOLANDE
BUILDING#2 ? �' F•
NO9TF- VIEW DRIVE
WINDSOR,CT 0605k� � � s tJ �`VINDSOR,CT 06074
PHONE 860-72 95
Al
WORK DESCRIPTION: REPAIR
THE DRAIN LAYER ASSIGNED TO THIS E T�]f�S A STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FOR I�I
�A AL RK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STAND I `
w n� T ANI)T ATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED BY
9/28/2009 9:11 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: Of OMS-7 CONTRACTOR: 1 0-yo - _Z.60
LOCATION: $ ?,— b�1'��1
TYPE OF WORK: � \ w-e
DATE INSP NEEDED: DATE INSP: I o� do
INSPECTED BY: 930
WORK IN
PROGRESS:_ (LoI&C42A (e 1/CP
y S' La-4 a,nd a= 2=° L eAd
e 12 & -e,, 7raPC
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: (1 � DATE: A- lK - 0
W/2007 Town of South Windsor INPSECTION REPORT 07
i
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: 977'i &-0riA%-4 i cvI A Lot #
Street No. Street Name
Premises owned by:
Name of Firm: -o .. Y�Dn�t el(- Phone: D &a-3-is 9 3
Address of Firm: o cr ti,o,11. Pke )P %d"McIs a,r CT-
TYPE OF WORK:
Lay House Drain ; Repair House Drain
Lay Main : Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with !encc o t: sd Ct -6 5
Existing Water Supply: Public Water '\ � Well
Proposed Start Date %2ko Estimated time for completion �3
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 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. -q,,ko5 mo05?
Signed: Print Name:- lqwt)-- Cdgfie.r +
Licensed Drain Layer
Date: 12 g
Standard Forms\PerrnPs\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF - SOUTH NINDSOR
SANITARY- - ;SEINER LATE RAL LOCATION
DATE OF CONSTRUCTION. 1
BUILDING ADDRESS 3
STREET Vlec3r�ye
SUBDIVISION:
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
04 ScY Vv C9m�l �a DATE
TOWN STATE ZIP INSPECTED BY TOWN
( 27w - DATE
TELEPHONE NUMBER
WHITE —JOWN PINK — CONTRACTOR YELLOW - CONSULTING ENGINEER f DEVELOPER