HomeMy WebLinkAboutDrain Layers Permits 1315 John Fitch Blv 1400014 TOWN OF SOUTH WINDSOR, CT
PENT NUMBER DRAIN LAYER PERMIT
DATE: 06/03/2014
GIS ID:47701315 = FEE: 60.00
MUNIS APPLICATION# 201400687 EXPIRATION DATE: 07/03/2014
APPLICANA `` LOCATION
NAME: J&H SLATER CON�ft- J ADDRESS: Ijf5 JE�HN FITCH BLVD
ADDRESS: 75 COMMERCE WAS' GOLDBRG LOUIS H ETAL
SOUTH WINDSOR,"CTv-060,74 - 38 HENLEY WAY
WE IfARTFORD,CT 06117
PHONE 860 52 -5252
WORK DESCRIPTION: SANITA&')-(3*E�AIR -
THE DRAIN LAYER ASSIGNED TO THINE E IIT HAS AUALID LICENSE ISSUED BY TH1-STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH'-IIN THE ATTACHED`CONDITIONS', ALL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHAREQUIREMENTS,AND THE ATTACHED CONDITIONS.
ISSUED BY DATE4NSPECTED INSPECTED BY
6/3/2014 8:22 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:-/ CONTRACTOR: ald
LOCATION:
TYPE OF WORK: 'taw (wo(k-104 on je j
DATE INSP NEEDED: DATE INSP: 9 �z
INSPECTED BY: 13 b
WORK IN
PROGRESS: cl
71
,5-e_LJe_-, �
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: -- DATE:
S/2014 Town of South Windsor INPSEMON REPORT 14
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:��)S J1� � �;"9 Lot #
Street No. Street Name
Premises owned by: Dqye GrOL-9 921AL&
Name of Firm: �'� S(A� Phone: ram- —521 S2S2
Address of Firm: f�J�1�L WiP1`� SNNk '^�,�v5 u`(L CT y b a�`'I
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres W ty4,N� ov4
Connection will be made with
Existing Water Supply: Public Water_ Well
Proposed Start Date � ( Estimated time for completion Z
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. 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: f�50 r� �'kASLn-
Licensed Drain Layer
Date:- 1�1
Standard Forms\Permits\APPLICAIION FOR DRAIN LAYERS PERMIT.doc