HomeMy WebLinkAboutDrain Layers Permits 1001 Dzen Way 750021 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
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DATE: 06/28/07 f
GIS ID:29351001 �'Y „ FEE: 60.00
MUNIS APPLICATION# 200700960 s� f:' y �/, h:
re EXPIRATION DATE: 07/28/07
APPLICANT
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NAME: PURINTON BUILDERS;AN't
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ADDRESS: 33C BRADLEY PARK LIVAll TOWN HOMES LLC
EAST GRANBY Cl 060y` ;. N. „.. } STREET
HE.STER,CT 06040 1
PHONE 860-653-06 n i,,:
WORK DESCRIPTION: NEW SE�ER'� t Y LDS
CONNECi40N' >6#,
THE DRAIN LAYER ASSIGNED TO THIS VR ITI . .Ix1; I ST[fifE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FOR . A IDS'. O1k"SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STAND S;� � ..� # q
THt�A TACHED CONDITIONS.
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ISSUED BY DATA` s"PEcTE-D INSPECTED BY
6/28/2007 1:51 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:_ 'ooa1 CONTRACTOR: Va
LOCATION:__ f r rtJ ADDRESS:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: >Iz S a
-INSPECTED BY: k1lb
WORK IN
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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: r0 0/ Lot # 1601
Street No. Street Name
Premises owned by: �)//I y /i � i!E
Name of Firm:7U) 6Z/AJMAJ u >s Phone:- c 5_3° 96�4
Address of Firm:,3,3 C 8a4z)LAe_kl E 0
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water Well
Proposed Start Date ' o� �� Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CON?,j
ITIONS ATTACHED TO THE PERMIT
Permit is to be issued to �S 2�'`' �5 / the holder of Drain
Layer's License No, 7X,5�5 3 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 Nod q S 2.
Signed: Print Name:< �%fS � AD
Licensed Drain Layer
Date: ,2�
Standard Forms\Permits\APPUCATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH ANDSOR
SANITARY SEWER LATERAL FIELD - LOCATION
DATE OF CONSTRUCTION: J /i4 c>20 0
BUILDING ADDRESS
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STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME NTRACTO S ERVISOR (PRINT)
STREET ADDRESS SIG NA RE"
4a t ?/zs��� DATE
TO pp STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER