HomeMy WebLinkAboutDrain Layers Permits 1648 Main Street 1100033 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 08/24/11
GIS ID: 54901648 FEE: 60.00
MUNIS APPLICATION# 201100959 EXPIRATION DATE: 09/23/11
APPLICANT ' ;" LOCATION
NAME: D&L EXCAVATION ADDRESS:, 1648-M 3N STREET
ADDRESS: 80 WILSON LANE { NER I -RSEY LAURA A&
VERNON ROCKVILIfE,C 06066 148 1GIA1N ST
SUUTH WINDSOR,CT 06074
PHONE 860-8754883
WORK DESCRIPTION: NEW SEWED CQNNCTIQI-
THE DRAIN LAYER ASSIGNED TO THIS I ERMIT HAS A VALID LICE
NSE ISSUER BY THE OTATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTIlIN THE ATTACHED"`CONDITIONS'..'ALI WORK SHALL BE IN ACCORDANCE WITH
RbS ALL OS�IA REt�U�REMENTS,
THE TOWN OF SOUTH WINDSOR STANDA ANI?THI;ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED
8/24/2011 11:59 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: -3 CONTRACTOR: Oci, L
LOCATION:
TYPE OF WORK: S.0 uj e r COy'y-\e CA4 b V'N-
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: J�
WORK IN !ps a
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SEPTIC TANK PUMPED, SMASHED, FILLED ?D WITNESSED PIES ❑ NO
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INPUT: 1 DATE: q 1-7 k
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVAN AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: P l 41'ti 5 7— Lot
Street No. Street Name
Premises owned by: /lC r�G o �S 'A!e 11 C'i
Name of Firm: � xG!q-v,j I t a e-1 Phone: J"'60"'
c-,
Address of Firm: c(w V,'-g ;off�i'd' 4
TYPE OF WORK:
Lay House Drain Repair House Drain ;
Lay Main v Latera for Commercial/Industrial
Building of acres
Connection will be made with t
Existing Water Supply: Public Water_ Well
Proposed Start Date �E� Estimated time for completion Op"' 1�
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 the holder of Drain
Layer's License No. c') O P 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.
PLEASE NOTE:
CBYD No. 9, �' (r Ya'G9'93 . IFA SANITARYSEWER LArmL
IS WITHIN 75 FEET OFA WELL
IT MUST BEAIR TESTED
Signed: Print Name: 4i�'tCJ�✓/'
Licensed Drain Layer
Date: c'
' Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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