HomeMy WebLinkAboutDrain Layers Permit 007 Carriage Drive 1100009 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 03/24/11 � _ O
GIS ID: 17100007 �A s FEE: 60.00
MUNIS APPLICATION# 201100211 % EXPIRATION DATE: 04/23/11
APPLICAN V--s� a f LOCATION
NAME: EAGLE EAR: V= :
REkRR�GE DRIVE
ADDRESS: 101 N MOUNTAIN R WALTER S&DOROTHEA A
CANTON,CT 06019 RRIGE DRIVE
PHONE 860-693 Ofi`=; ff
� DSOR,CT 06074
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WORK DESCRIPTION: NEW SE I
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THE DRAIN LAYER ASSIGNED TO THIS i
§A V 1SSU � ATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FOR A T j AM�RK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STAND �� O � T;As"-T�rATTACHED CONDITIONS.
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ISSUED BY DATE SPECTED INSPECTED-BY
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I D CONTRACTOR: boeck
LOCATION:
TYPE OF WORK: Aho_c ) �Aa)Le-t__ co l� o
DATE INSP NEEDED: DATE INSP: :34 I1
INSPECTED BY:
WORK IN I
PROGRESS: r_bn fmc4vr . s l y "Ptr- S. 2 -�a� rim s�
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED dYES ❑ NO
AS-BUILT:
INPUT: i DATE:
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: � G Lot #
Street No. Str t Name
Premises owned by:, a1?1z&A1Al2 �0/'45
Name of Firm: �E hk f, t At hW a/k. Phone:
Address of Firm: A u-tQkk K�� ����1
TYPE OF WORK:
Lay House Drain_; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with cloyc
Existing Water Supply: Public Water_ Well
Proposed Start Date 3 -Z S 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 n%o� W'ita 00(' the holder of Drain
Layer's License No. z y Ail b 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: _ _ - Print Name: , --
Licensed Drain Layer
Date: 3 2 0011
Standard Forms\PermitsyPPLICATION FOR DRAIN LAYERS PERMIT.doc
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Planimetric data provided by SBC under contract and is based
on an aerial flight performed in spring of 2005. Continuous
7
/ CARRIAGE DR updates completed with As-built information and CRCOG aerial wis
sot
flight performed in spring of 2009.This map is a graphical
TOWN LINE PARCELS representation ofproperty information and is subject to change.
® The Town of South Windsor and SBC assume no legal responsibility
4�eson.coN� for information depicted on this map and is to be used for planning G {,� v tn�f<=r APh; mvlk,e F�m
1 inch = 40 feet purposes only.
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