HomeMy WebLinkAboutdrain layer permit 95 Lavender Lane 900016 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
mW DRAIN LAYER PERMIT
DATE: 04/28/09 `#
GIS ID: 52600095 , v> ::":"t<r ...
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APPLICATION# 200900402Y ' `T .`; "' °a"A `->4 .. ¢ FEE: 60.00
S J. ' `,�. '" IRATION DATE: 05/28/09
APPLICANT ,
n g.LOCATION
NAME: JACQUES CONSTR jpT Jq `
:r '. , t AVE. DER LANE
ADDRESS: 67 RIDGE RO
UT �- ` ,j i ION
CO WINDSOR RUCTION INC
SO
8 ELLINGTON ROAD
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PHONE 860-432118 '�, r 7 W�NDSOR,CT 06074
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WORK DESCRIPTION:
NEW SEVE `;Ct3.,,
THE DRAIN LAYER ASSIGNED TO THIS A ry ' �s
THE TERMS AND CONDITIONS SET FORThl. B `< TAT A E Y G S O LL
THE TOWN OF SOUTH WINDSOR STANDC IS LG �2K SHALL BE IN ACCORDAN ITH
, F1�?I$, jvD TI ATTACHED CONDITIONS.
ISSUED BY V DAT IN ECTED INSPECTED BY
4/28/2009 3:48 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 0 01.(, CONTRACTOR:
LOCATION:
TYPE OF WORK: _
- =---- = DATE-INSP NEEDED: DATE INSP: zo?z
INSPECTED BY: 6
WORK IN
PROGRESS: Gaol 3
247
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INPUT. '� 1
DATE:
W/2007 Town of South Windsor-INPSE-MON REPORT 07
�l
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: 9_ ,2,21hegdpr_l A—_Lot #
Street No. Street Name
1
Premises owned by: ccaAs— U / `F
Name of Firm: TAvv--2 Phone:
Address of Firm: G7�9 l
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 O 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 �'tut older of Drain
Layer's License No. 908'9 3 O . 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: Print Name: 1, O: ,A J4 Cat 0
Licen Layer
Date: a
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY - SEWER LATE RA'L -LOCATION
DATE OF CQNSTRUCTION:
BUILDING ADDRESS 9 '
STREET -V r N D a L 41-it
SUBDIVISION: Ti,,A ��
NORTH ARROW
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CONTRACTOR (PRINT) 1f"—' NAur OF C NT SOR (PRINT)
75:
ADDRES SIGNA RE
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ATE
T STATE ZIP
cy INSPECTED .BY TOWN
G�G ! DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING .ENGINEER / DEVELOPER