HomeMy WebLinkAboutdrain layer permit 3 Copper Ridge 900066 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
DATE: 11/13/093£ DIN LAYER PERMIT
GIS
ID:23500003 y
MUNIS APPLICATION# 200901396 � FEE: 60.00
EXPIRATION DATE:
12/13/09
APPLICAN
NAME: J&H SLATER CONS — LOCATION
ADDRESS: 75 COMMERCE WA - OPPFWk RIDGE
SOUTH WINDSOR, = $ 4fPI LCO INC
`14'ELLINGTON RD
PHONE 860-528 _ INDSOR,CT 06074
WORK DESCRIPTION: NEW SEVk
At _
THE DRAIN LAYER ASSIGNED TO THIS P HASlssH
A STATE AND HEREBY AG LL
THE TERMS AND CONDITIONS SET FORTH
THE TOWN OF SOUTH WINDSOR STANDARD T- RK SHALL BE IN ACCORDANCE WITH
-4 ND ATTACHED CONDITIONS.
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ISSUED BY
ATE INSPE TED INSPECTED BY
11/13/2009 12:55 PM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 9 w O CONTRACTOR: 'S I c- f Ci2
LOCATION:_ �T
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: &116l'09
INSPECTED BY: 13h
WORK IN
PROGRESS: _ r� /OVG 5t>/2- 3 S
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: L DATE: )) 1 0 J
W/2007 Town of South Windsor INPSECTION REPORT 07
9 0006 r,
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
� 2 Location of proposed work: Lot # K
Street No. Street Name
Premises owned by: `�-
Name of Firm: 75QA j 6L Phone: st'�2--
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 Mlo Estimated time for completion 2
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 -�A . '5c.0 76A- the holder of Drain
Layer's License No. Zo-T-7�Aq . 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. Cq 2��
oe
Sign Print Name:
Licensed Drain Layer
Date:
Standard F0M1S\Pe=ts\APPLICATION FOR DRAIN LAYERS PERMrr.doc
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