HomeMy WebLinkAboutDrain Layers Permit 31 Balsam Fir Road (2) 900003 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 02/23/09
GIS ID:07150031
FEE: 60.00
MUNIS APPLICATION# 200900127s..; y, �•> ;� EXPIRATION DATE: 03/25/0
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APPLI A ':-`' LOCATION
NAME: MANNARINO BUIL
ADDRESS: 400 CHAPEL ROAD` ' BAT- FIR ROAD
t O BUILDERS INC
UNIT 3F „
9 t GTON RD
SOUTH WINDSOR,�6 7; f •.:
. � �t �VINDSOR,CT 06074
PHONE 860-28�705 s
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WORK DESCRIPTION; NEWS u O, a
THE DRAIN LAYER ASSIGNED TO THIS ER41T A, SAS T PSTATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FOR fI M S' RK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDA k�L t ;I�t 14 N T N�ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
2/23/2009 3:14 PM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: Cf 0000 3 CONTRACTOR: V"CA Vl noLr,
LOCATION: 13
TYPE OF WORK:_ ,0 yl
DATE INSP NEEDED:
DATE INSP: 3 /ate
_ INSPECTED BY: Aeb
WORK IN
PROGRESS:__
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INPUT: C DATE:_ �-q ' O q
W/2007 Town of South Windsor INPSECTION REPORT 07
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:- 31 Ook9st F'r X lb, Lot # _
Street No. Street Name
Premises owned by:_ A�C(^�
Name of Firm:_ E4 Q j e F�*rAWO J_k 5efy,;C,& Phone:
Address of Firm:_01 Ala-p-A /4A R p :&tv 4*�, C
TYPE OF WORK:
Lay House Drain ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
of
Connection will be made with P
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 _ Ni le to, toy the holder of Drain
Layer's License No. _J-7i I I . 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. ; j
� 1
Signed: Print Name:_ 4 4qe,1 17 C y
Licensed Drain Layer
Date:
-` Standard.Forms\Permits\APPUCATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FfELD LOCATION
DATE OF
CONSTRUCTION.
BUILDING ADDRESS
STREET ;
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT). NAMIE ( CONT. CTO S. UP OR (PRINT)
STREET ADDRESS / SIGNATURE
DC0/ = ..� DATE
312
TOWN /G STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN -PINK - CONTRACTOR YELLOW - CONSULTING .ENGINEER j DEVELOPER