HomeMy WebLinkAboutdrain layer permit 123 Mark Drive 900007 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 03/24/09 �
GIgll): 57000123 `
f FEE: 60.00
MUMS APPLICATION# 200900225 r3 .- b � �; EXPIRATION DATE: 04/23/09
APPLICAN' :.
DRE LOCATION
NAME: ROOTER EXPRESS3�1YIATK DRIVE
ADDRESS: P O BOX 290549 .LI VtTAYNE R&CAROL J
WETHERSFIELD C04 ` �
�h
1 �, �: •�, .• �"` �•. �a1r. ARC DRIVE
=8 £` �% � SOR,CT 06074
� sHONE 860-24
4s c
WORK DESCRIPTION: NEW S�
THE DRAIN LAYER ASSIGNED TO THISk' E TgY U ATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORS a` �s ,.• F
"TH (5
IS AL "yW SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDASiS p IATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
3/24/2009'8:44 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: ow o CONTRACTOR:
x
LOCATION:
TYPE OF WORK: /V ew w-ar �o y► ��,
DATE INSP NEEDED: DATE INSP: 3 a
INSPECTED BY: 8D
WORK IN
PROGRESS:_C 00ve sba �P
2-G 0 �
CrvS4e�(
AS-BUILT:
INPUT: L� DATE:_
W/2007 Town of South Windsor INPSECTION REPORT 07
perm�� � 90oOo
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
p dO49 aadd5 PUBLIC WORKS DEPARTMENT
a P TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: /a 3 tot #
Street No. Street Name
Premises owned by: &,/"p
Name of Firm: Phone: $50
Address of Firm: Po Rak o2 F&7-D,
TYPE OF WORK:
Lay House Drain ; Repair House Drain
Lay Main Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with _5PR 3 5 I�NC /r=E'PNco
Existing Water Supply: Public Water Well
Proposed Start Date_ 3-02 4 09 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 Z�Fi✓k_"sT i• kocT/ the holder of Drain
Layer's License No. ,19/ -aD47f 3 . 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.
Signed:9 Print Name:
Licensed Drain Layer
Date:
Standard FDrms\Permits\APPLIGATION FOR DRAIN LAYERS PERMIT.doc
� e � i � •
. � � � � � � �
� � � � � ,.
i � � � •
� :
: � �
,. ..,
� .i � i II
■ 1��_
�� � � J �.
�- - • �� �
i ■ ■
_� � ■ �
■
■
� ; .
_ ,�► ■
■
,� , , ,. .,
,� .-
r
,,.
�„ � •� / .�
i �
� �