HomeMy WebLinkAboutDrain Layers Permit 22 Balsam Fir Road 900012 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
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DATE: 04/09/09 ,
GIS ID:07159999 "'"` '°
�7`f;�sy.,,>•. w Y .may FEE: 60.00
MUNIS APPLICATION# 200900315 ;Al ° .q t" EXPIRATION DATE: 05*109
APPLICA " \LOCATION
NAME: EAGLE EARTHWO B�ALS TT FIR ROAD
ADDRESS: 101 N MOUNTAIN . d., ` ,<. • :N ;.. 'y ;..
�' v�0 SOUTH WINDSOR
CANTON,CT 0601 t " Oil IVAN AVE
y K. S R,CT 060742734
PHONE 860-69 202g` ' `
WORK DESCRIPTION: NEW SE
THE DRAIN LAYER ASSIGNED TO THIS`?E T A� r S ." .TATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORT4 y . C RK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDA R � ATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED BY
4/9/2009 3:22 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 0001� CONTRACTOR: �o
LOCATION:— a,
TYPE OF WORK:
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INSPECTED BY: 8Z
WORK IN
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SCANNED
W/2007 Town of south Windsor INPSEMON 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:--I lsg %, �' 11lot #
Street No. Street Name
Premises owned by: //�Y a it N'r"w O
Name of Firm: Fci(l WC7t Phone:��
Address of Firm: volp—ilt
TYPE OF WORK:
Lay House Drain_; Repair House.Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with l tx"
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 M,t,44 ef &/,1ISOx the holder of Drain
Layers License No. �719 116 . 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.
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Signed: �! c
9 Print Name: k
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Licensed Drain Layer
Date: `0
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