HomeMy WebLinkAboutdrain layer permit 249 Lawrence Road i
900018
PERMIT NUMBER TOWN OF SOUTH W I N D S O R C
'. .4. DRAIN LAYER PERMIT
DATE: 05/05/09 �� �° '>,.
GIS ID:52800249 <� � "
MUNIS APPLICATION# 0900444
ATIO 20 >
APPLIC r # } ` `} .t ; pT�y s.T. N D FEE: 60.00
EXPIRATIO ATE:
NAME: ANC' ,, n, 06/04/09
JDC ENTERPRISES
ADDRESS: 420 JOHN FITCH BLS { ' � .�LA M LOCATION
� v �tENCE ROAD
ow
SOUTH WINDSOR, y � F ,..� TDNALD H
PHONE px ., 9 LAW'
860-667401 NCE ROAD
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SOR, CT 06074
WORK DESCRIPTION: NEWSE' V
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ASSIGNED TO THIS BE'
RAIN LAYER VRA A
THE TERMS AND CONDITIONS SET FOR �THE TOWN OF SOUTH WINDSOR STAND S A ;SSA '` . SSU y B F TE AND HEREBY AGREES TO ALL
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ATTACHED CONDITIONS.
ISSUED BY
5151200910:04 AM DATE INSPECTED
INSPECTED BY
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:
CONTRACTOR:
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:-��/�/o
INSPECTED BY: e D
WORK IN
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SCANNED
W12007 Town of South Windsor INPSEC(ION REPORT 07
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00 CAN
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Location of proposed work: C��9 ��w�Q�'6U� /� Lot #
EL)
Street No. Street Name
Premises owned by:14/ /1J�
Name of Firm: �� =i!/7�7c�/�/SC3 �� Phone: 4��7�8 40'V
Address of Firm: �e� 6t/1't4'POI
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
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 �%d 16�141 2� cw.2c=`7 the holder of Drain
Layer's License No. n ao r,12A ./..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. d
Signed: Print Name: � te(7
Licensed Drain La
Date: :5
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
Dirabek, Bernard
From: Cal[Center@CBYD.com
Posted At: Thursday,April 30, 2009 2:32 PM
Conversation: Locate Request-20091802950
Posted To: CBYD
Subject: Locate Request-20091802950
(CALL BEFORE YOU DIG - CT) 04/30/2009 14:31:54
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***** ROUTINE *****
TIME. . 14:31 DATE. .04/30/2009 SCANNED
REQUEST NO. . .20091802950
LATITUDE. .41.8560357 LONGITUDE. .-72.5094753
TOWN. . . . . .SOUTH WINDSOR l L
.✓
ADDRESS. . .249 {
STREET. . . .LAWRENCE RD
NEAREST
CROSS STREET. .CLIFFORD DR
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TYPE OF WORK. . . . .EXC TO INST NEW SWR PIPE
AREA IS MARKED. . .YES
REMARKS:
WORKING FROM THE STREET TO THE REAR OF THE HOUSE
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START DATE. . . . . .05/05/2009 START TIME. .07:00
CALLER. . . . . . . . . .DAWN OUELLETTE
CALL BACK. . . . . . .8-5
PHONE #. . . . . . . . .860-667-4800
FAX #. . . . . . . . . . .860-667-4164
ALT. PHONE #. . . .
EMAIL ADDRESS. . .
CONTRACTOR. . . . . .J D C ENTERPRISES
ADDRESS. . . . . . . . .2640 BERLIN TPKE
CITY. . . . . . . . . . . .NEWINGTON
STATE. . . . . . . . . . .CT
ZIP. . . . . . . . . . . . .06111
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EXCAVATOR DOING WORK. .SAME
ISSUED TO: DATE: TIME: BY:
DATE/TIME ARRIVED: TIME LEFT: COMPLETED BY:
CALL BACK: 1) DATE: TIME: BY: 2) DATE: TIME: BY:
PERSON CONTACTED: PERSON CONTACTED:
1
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERALIIELD LOCATION
DATE-OF CONSTRUCTION: __- s= s o4
BUILDING ADDRESS ---: . air 4
STREET V�O.
SUBDIVISION:
L U
NORTH ARROW
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O
A To Z .�
CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVI R (PRINT)
LA'DLp -> 'AsN ll�
STREET ADDRESS SIGNATURE
TE
TOWN STATE ZIP INSPECTED BY TOWN
$r,0 : DATE
TELEPHONE NUMBER
WHITE -'TOWN PINK - CONTRACTOR YELLOW-- CONSULTING .ENGINEER / DEVELOPER