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HomeMy WebLinkAboutdrain layer permit 1425 Main Street 900010 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 04/02/09 _.� , GIS ID: 54901425 r � MUNIS APPLICATION# 200900272 f ,'.'' ` ` ., 6 FEE: 60.00 ' k` : '>: .ay`*: EXPIRATION DATE: t ..:: :,' s OS/02/09 APPLICA ...;,a, < , LOCATION NAME: JAC UES CONST O «1: '. 5 ADDRESS: 67 RIDGE ROADf STREET �< • •:,�•` ». ;;,� . r .• s �3B'yTHOMAS J& SOUTH WINDSOR t F." .'. `.. ,:.�� � f� ;`,� ..,..���.;..: .. 2 M"ATST - WNDSOR,CT 06074 PHONE 860-432 M3. ; WORK DESCRIPTION: REPAIRTAw-Mal, Y . ED THE DRAIN LAYER ASSIGNED TO THIS AE IT XAq A £ S TIIE TAT] AND HEREBY A THE TERMS AND CONDITIONS SET FORT�I�'T,�I . .I CIS. 3.. 5', L (SRK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDAIM $ jLr ' �i 'AF& 5 : NTSxI H ATTACHED CONDITIONS. to ISSUED BY DATE SPECTED INSPECTED BY 4/2/2009 8:31 AM TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.:NO.: of � I C� CONTRACTOR:_ c��►n �--- LOCATION: �aS iJY�a t TYPE OF WORK: Q" 6 ( DATE INSP NEEDED: DATE INSP: It INSPECTED BY: 8,O WORK IN PROGRESS: ;m"co4&- Pyc SC"} �WD Fr�•n N��v a y- c�-wd © �► l�wck AS-BUILT: k INPUT: eO\ DATE: y' 6-0 SCANNED W/2007 Town of South Windsor INPSECTION REPORT 07 1 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: ya�S- n S Lot # Street No. Street Name Premises owned by: T©wL Name of Firm: -TQ l xjes' �l�l� Phone: 3a 103 Address of Firm: S(�tJ TYPE OF WORK: Lay House Drain ; Repair House Drain ; Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with SG -er/P1-DC Existing Water Supply: Public Water 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 0ky1--S4LQU-e-1 the holder of Drain Layer's License No. '�D&IF30 . 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. SCAIVNED Signed: 0 Print Name: 32 tad�S Lice se r n ayer Date: standard Fo swermits\APPLICATiON FOR DRAIN LAYERS PERMIT.doc w F r � ■