HomeMy WebLinkAboutdrain layer permit 63 Frazer Fir Road 1000024 TOWN OF SOUTH WINDSOR CT
PERMIT NUMBER
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DATE: 05/26/10 mvmvvnri+m gV\V\q;
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MUNIS APPLICATION# 201000625 ° , \\ °` \a�\ \\\ \ri\�\\\�\ FEE: 60.00
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NAME: EAGLE EARTHWORKS \ �� ��`, v AV' vas �,v ,v �\vv ALOCATION
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ADDRESS: 101 N MOUNTAIN R a��v °` �'av \� V ���,6 R FIR ROAD
O BUILDERS INC
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CANTON CT 06019 � � vvv`v vv� � v� ,vv,
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860-693— � � v`V'a��` \v ;v�v0\\�\°vA� Awq\ h. SOR,CT 06074
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WORK DESCRIPTION: INSTALL ,, ,� ' ��� """v" ��
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THE DRAIN LAYER ASSIGNED TO THIS P
THE TERMS AND CONDITIONS SET FORTH H TATE AND HEREBY AGREES TO ALL RK
THE TOWN OF SOUTH WINDSOR STANDARDS y ° T�y��� L SHALL BE IN ACCORDANCE WITH
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5/26/201010:05 AM DATE INSPECTED INSPECTED BY
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO,: 10000 a � CONTRACTOR:
LOCATION: lk,3 /" Y°z 12 o f
TYPE OF WORK: �^ ✓► C� a1
DATE INSP NEEDED: DATE INSP: 57-/g 7 116
INSPECTED BY: - ,9
WORK IN
PROGRESS: L'(9'yl"C�o,.C��-n� T-�+s �wl CR" ►OVC 5D12 3 S f r y
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:-
INPUT: DATE:
W12007 Town of South Windsor INPSECTION REPORT 07
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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: G�V 7 G Lot #—�
Street No. Street Name
Premises owned by: AuaD L Ide)
gcK3o-& Name of Firm: &k Phone: -24Z
Address of.Firm:
TYPE OF WORK:
Lay House Drain,_;, Repair House Drain
Lay Main - Lay Lateral for Commerdal/Industrial
Building of acres
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Connection.will be made with AL",
Existing Water Supply: Public Water "\ Well
Proposed Start Date 5 �-0 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 616�atlj the holder of Drain
Layer's License No. �7 Ph . 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. 70 tO ZZ 90 52
A4Signed: °G�C�P � Print Name
Licensed Drain Layer
Date: 7 b l0
Standard FDM1S\PerMb\APPUCATI0N FOR DRAIN LAYERS PERMrr.doc
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