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HomeMy WebLinkAboutdrain layer permit 190 Lawrence Road 1000053 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 10/07/10 3 GIS ID: 52800190 s MUNIS APPLICATION# 201001376 y FEE: 60.00 � EXPIRATION DATE: 11/06/10 APPLICAN � � LOCATION 4 yy NAME: J D C ENTERPRISES I 1 I)LA* ENCE ROAD ADDRESS: 920 JOHN FITCH BLU FRANK J&KAREN M S WINDSOR,CT 060 =.� (I LAM ROAD Pot NW-0 M9�y PHONE 'y� y - 1 'VNDSOR,CT 06074 as l ��� WORK DESCRIPTION: NEW SE ( TI s smON THE DRAIN LAYER ASSIGNED TO THIS SAY - SSUF15 Y-%lt TATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FORT A� T-ON SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDL � -Al I IATTACHED CONDITIONS. OR /o ISSUED BY DATE INSPE TED INSPECTED BY 1 0/7/20 1 0 2:20 PM ------------- .....----------------- Up 40 �� �xy Aff § i 4 g - _ -q i y �3 �- TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: I ODDS S� CONTRACTOR: , LOCATION: �C ( )r'E ry e e©w e�7Q TYPE OF WORK:_A?t°(A) P(,c (� ►n 1�rA�PDY� DATE INSP NEEDED: DATE INSP: INSPECTED BY: WORK IN PROGRESS: !'vc sDa 3?Sib..1 SAL 3A r Cr., 51W Jg4A_.Q A 4-0 / cA4-h 41i_ Puy /o yn' SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES 2'NO AS-BUILT: f INPUT: �� DATE: S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION 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:_ Z-2O ie,a Lot # Street No. Street Name Premises owned by: >�%�' �K c 2 0y7-/4 Name of Firm: C" /�22�/'�c� Phone�1,' �P Address of Firm: f V `� •� ,��r c�yc ,,� vt� wl,,44 rem TYPE OF WORK: Lay House Drain Repair House Drain ; Lay Main : Lay Lateral for Commerdal/Industrial Building of acres Connection will be made with 3 S_ Existing Water Supply: Public Water Well Proposed Start Date!�O- �-/0 Estimated time for completion / A 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 1002 0 013 -P 7 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. Signed: not Name: C7��-- Licensed Drain Layer Date: SWKIaM FormSXPermltSWWCATION FOR DRAIN LAYERS PERMIT.doc i � 1 � 1 1 1 r am • �► S 1 � 11 ' � CI 1 1' •/ ' � : I s � ■ � r � � ,�, �� ■ s ■ ���� . � � � �� � �� � � �� i ' ���; � �� r ■ram � -� � � � �����r� � _���� IMF l'�� � ■ �� _ �1�� ��l�� � s� -- . . . . ►i i i' •• 1 / 1' /• •• . ��- — S 1 � � / � ... :ram �� i s