HomeMy WebLinkAboutdrain layer permit 38 Copper Ridge 800050 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
DRAIN LAYER PERMIT
Dt,TE: 09/17/08qNj N
GIS ID:23500038 d � .
MUNIS APPLICATION# 200801447 '``' r_ FEE: 60.00
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°' < ,:: ,< EXPIRATION DATE: /17/08
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APPLICAN ,$. ;a
NAME: J& ry LOCATION
II SLATER CONS. CO" .<..,:...:
ADDRESS: 75 COMMERCE WA s` - t :' PPR RIDGE
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SOUTH WINDSOR T54 ,` A # E R KI CO INC
6
LLINGTON RD
PHONE 860-5285 k�� 1VNDSOR,CT 06074
WORK DESCRIPTION: NEW SE E
THE DRAIN LAYER ASSIGNED TO THIS E I
�� [ SY S1ATE AND HEREBY AGREES TO ALL
TERMS AND CONDITIONS SET FOR�I,�: w—Ml—
THE THE TOWN OF SOUTH WINDSOR STANDA SSHALL BE IN ACCORDANCE WITH
IiF ATACHED CONDITIONS.
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ISSUED BY EV/
IN SPECTED TED BY
9/17/2008 2:03 PM TE I
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 8 000 SO CONTRACTOR: -' a- < Q
LOCATION: 3
TYPE OF WORK:---..,& Q +r
-DATE INSP NEEDED: DATE INSP: 9/L
_ INSPECTED BY: g
WORK IN
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AS-BUILT:
INPUT: DATE:_
W/2007 Town of South Windsor INPSEMON REPORT 07
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
a 0O 80/�,�7 PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work.`38 �a /Z RI'D/et Lot #
Street No. Street Name
Premises owned by: L
Name of Firm: �u� •ne
Ph .
Address of Firm:
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 X Well
Proposed Start Date Estimated 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 tJ 7
the holder of Drain
Layer's License No. d7 76 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 agdd ttached thereto. Applicant has received
Town Streel Excavation Permit No. lJ and/or ConnDOT Permit Na
CBYD No. E 3800 2_�Z:5/
Signed Print Name:
-� /Z-
Licensed Drain Layer
9117Date:
: : Stamard:Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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TOWN OF SOUTH WINDS0R
SANITARY SEWER LATERAL , FIELD LOCATION
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DATE. OF CONSTRUCTION: d
BUILDING ADDRESS
STREET : C fl 10G
SUBDIVISION: C 0f Oz- �Cr
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIG RE
J w 1 tl-'�VL CA- OLwo`'i DATE
TOWN STATE ZIP INSPECTED BY TOWN
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TELEPHONENUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER