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Home My WebLink Aboutdrain layer permit 75 Lewis Drive 900004 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER.PERMIT DATE: 03/11/09 o GIS ID: 53400075 FEE: 60.00 MUNIS APPLICATION# 200900173 EXPIRATION DATE: 04/1 Of09 APPLICA T LOCATION NAME: K&B DIVERSIFIED14 I s. �'�5k LEWI$DRIVE ADDRESS: 42 SOMERS ROAD PCQG VINCENT J&SARA RACHELLE ENFIELD,CT 06082: ,� > '" I,EWI DRIVE PHONE .:n k'. �t � � I� I V INDSOR,CT 06074 WORK DESCRIPTION: INSTAL ,Smd a E M THE DRAIN LAYER ASSIGNED TO THIS��T A SS "T.-T TATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FOR T-��-A, C AI �CfVV£1RK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STAND ;'tI (� • ' . Q I � ATTACHED CONDITIONS. .. AN V ISSUED BY DATE INSPECTED INSPECTED BY 3/11/2009 1:40 PM m TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: q0000qCONTRACTOR: I t 6 Di ve(sfi S--)")4 LOCATION: 1 n 1 r ,�,� 7S wo rk TYPE OF WORK: =---= ------------------ -DATE INSP NEEDED: ` DATE INSP:__ T INSPECTED BY: WORK IN PROGRESS:_ C`A., r ��s�, l�o,� P r cT,r� 3 C Fro,. sf.tb 1 y 'D ma.sf-eA_ ao.6, r�1 AS-BUILT: Q/ INPUT: DATE: ..o WJ2007 Town of South Windsor INPSECTION REPORT 07 APP 2oogoorn op Per r 9cvoo4. APPLICATION FOR DRAIN LAYER PERMIT w TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WI CT FE $60.00 Location of proposed work: 2S ��/,� �/'hV C Lot # Street No. Street Name Premises owned by: I'IN Cc/,4 1 PacA u ,,-4 Name of Firm:_ ° -4 11J 1)(vcf.)i Fle e JeCUi'c t �,LC Phone: �(b07�6 S-0© I Address of Firm: 30-2 TYPE OF WORK: / Lay House Drain ✓ ; Repair House Drain ; Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with Existing Water Supply: Public Water__ Well Proposed Start Date // © Estimated time for completion o 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 issue to C\ V l 61 the holder of Drain Layer's License No. M .0)2 1 ( "P.70nly 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. /o; n�s Signed: Print Name: ljr�alq Li ensed Drain Layer Date: 3 /7 o Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc ® "11 1 ■� � � "sill ,' �� , � • - No .