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HomeMy WebLinkAboutdrain layer permit 114 Clinton Drive � f : 1 1 1• 'i 1 1' .. i i � ,,.,r`1• 1. .. i 1 :yl i • i i 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: L�fi # Street No. Street Name Premises owned by: Name of Firm:--_ / /r�,�` �n/sue Phone:-GO b o Address of Firm:_. TYPE OF WORK: Lay House Drainer 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 the holder of Drain Layer's License No. ,�2 2 � �. 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. , © � DD9 f 46 7 �j a Signed: A,� rint Name: Licensed Drain Layer Date: Standard FOrms\Permit WPLICATION FOR DRAIN LAYERS PERMrr doc TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: ODoar�S CONTRACTOR: .hand%e 60MST-P LOCATION: l y Gli n h 'hic TYPE OF WORK: 4 �� � DATE INSP NEEDED: J DATE INSP: INSPECTED BY: 06D WORK IN PROGRESS:--ron 0-L, rip-0- �O R- r 00 44 Ce, o� - G PJC SD2 w `3 S p VC C/".'All a—vt, T-4-PIC SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: �`- W12007 Town of South Windsor INPSECTION REPORT 07 1000005 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT y y DATE: 02/05/10 GIS ID: 21300114 �'� MUNIS APPLICATION# 201000112Ano ` FEE: 60.00 y _y�� EXPIRATION DATE: 03/07/10 APPLICAN � LOCATION NAME: LANDIE CONSTRUC ADDRESS: 21 CLARK ROAD — 1LITON DRIVE �Q)�IANTHONY W&SUSAN A BOLTON,CT 06043 s h "� CLII--, .TON DRIVE PHONE860 2 �� �INDSOR,CT 06074 860-646 305> �� _ 18 s 1 _ WORK DESCRIPTION: SANITAP �J THE DRAIN LAYER ASSIGNED TO THIS - IDS A - BSUII' TATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FORT T1 12C IIIv RI{SHALL BE IN ACCORDANCE WITH H =, THE TOWN OF SOUTH WINDSOR STANDARD ? Q�EMAT ATTACHED CONDITIONS. mh ISSUED BY DATE INSPECTED INSPECTED BY 2/5/2010 12:12 PM 'If 3 Jhi�Jfll Sao la J - = "£ s N�y y _ spy �� Vpw