Loading...
HomeMy WebLinkAboutdrain layer permit 965 Sullivan Avenue 0,4/27/1999 10:09 3606447280 SOUTH WINDSOR PAGE 02 APPLICATION FOR DRAIN LAYER PERMIT69P'4 TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Location of proposed work: 5�9����9r� ,AA✓&_- Lot # Street No. Street Name Premises owned by: i�i S 5�E'i",S &77- Name of Firm: 1—j"®SG 0 � L Al Phone: � �vw � D(� 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 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 _77:�'a ©s ���c the holder of Drain Layer's License No. � O �'� , Only holders of P1, P7 & W9 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. Signed: ��._ 6 _ Print Name: v Licensed Drain Layer Date:^ ��—>:. _I� Standard Forms\PermltsyAPPUCArON FOR DRAIN LAYERS PERM1TAOC • 1 . AZAI NV. Ji.•'e0 - —1 \ �/F A.7• SE.DAGL +, 1Nv. 9o.os0 PROPOSED 4E COMMERCIAL a ' S. W 1 N D S-O►, COMME<ZCIA1_ INVESTM r�TS' iNC , SCALE I =tO 88 1 1` l (' NOTE= TOPO LINE 1•ROM U-S go ! FF t1t.0 1i i 7ytEATE�2 Svr p�MERtC^N OIL \ 9 � -�5� — se- 5 Av E. ------ -b--- _ _ p_ _ I iNv j 1 Pe mit No. 6984 Town of South Windsor, CT Pe mit Date 05/11/1999 Drain Layer Permit Ex iration• Date 06/10/1999 De crip: SANIT. SEWER RELOCATION DUE TO BLDG. ADDITION Applicant �� Location Name TED ROSICK CONSTRUCTIO Aar SULLIVAN AVENUE Add r. 1919 BOSTON POST RD. 4 GUILFORD CT 7 � Phone No. (860)669-213314 eE � fF The Drain Layer a 'a� s a r s �t - 1 cense issued by the state and hereby agr t �, nd 1� s set forth in the attached 'Conditions'' 1 k n a � n with Town of South Windsor standards, al d t ched conditions. . y Issued By �• ���� � t� � ���^�� Date Inspected sDet ..,. . .. .. .� ... vvrc L.-OWI F IOLUM-kIf I1G !UE L.UI i jPjULjUj i 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 m ©s /Z(- the holder of Drain Layer's License No. ® O Only holders of Pj, P7 & Wg 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. -�-. Signed: O;ZkO7-ta� Print Name: c� v Licensed Grain Layer 6 Date: Standard Forms`Penn1t9\APP1ICAT T0N FOR DRAIN LAYERS PERMIT.doc