HomeMy WebLinkAboutDrain Layers Permit 28 Balsam Fir Road (2) 900014 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER � DRAIN LAYER PERMIT
DATE: 04/09/09
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GIS ID: 07150028 FEE: 60.00
MUNIS APPLICATION# 200900318 /// a
` r •s v : ,x :.." EXPIRATION DATE: 05/09/09
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APPLICA T _ h LOCATION
NAME: EAGLE EARTHWO. • 9 FIR ROAD
ADDRESS: 101 N MOUNTAIN " �P�IN. �' ��` r. f m" O BUILDERS INC
CANTON,CT 06014 �
3 INDSOR,CT 06074
PHONE 860-69 -20
WORK DESCRIPTION: NEW S e ••� k. M
THE DRAIN LAYER ASSIGNED TO THIS6 A iT'I §S. ., T STATE AND HEREBY AGREES TO ALL.
THE TERMS AND CONDITIONS SET FOR r .
THE TOWN OF SOUTH WINDSOR STANDA x �� RK SHALL BE IN ACCORDANCE WITH
.� �T E ATTACHED CONDITIONS.
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4/9/2009 3:56 PM -
ISSUED Y DATE SP CTED INSPECTED BY
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: L6�/v CONTRACTOR: &/so .`�c1ic✓ S
LOCATION:_ a �a�S�v�•, �'2
TYPE OF WORK: YL2W
_-= --DATE INSP NEEDED:
DATE INSP.—.�//z 7 0
INSPECTED BY: (3�
WORK IN
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INPUT: C DATE:
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: -9q 6-Itze P r Pb Lot # 2-z
Street No. Street Name
Premises owned by:_ /` almoo'zi 9-'1 AA^r
Name of Firm: f%6010 IF_(y®` L-'�kJC �'edv.`edphone: �:zee 7
Address of Firm:- 0 / P AW, 2 p (v2t C pl
TYPE OF WORK:
Lay House Drain_; Repair House Drain -- ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with 0 o
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 Af6&d W the holder of Drain
Layer's License No. . 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.
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Signed:-A- t Name:__ "1��2�� ��jc�c
License Drain Layer
Date:_
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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