HomeMy WebLinkAboutDrain Layers Permits 9999 Cliffwood Driv (2) 900049 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 08/04/09 '"
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GIS ID:21009999 f � �� . FEE: .00
MUNIS APPLICATION# 200900921 � EXPIRATION DATE: 09/03/09
APPLICANT s ., = $_ 3�v LOCATION
NAME: GERBER CONSTRUC ONt
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+, _ OOD DRIVE
ADDRESS: 1 NUTMEG DRIVE E UTH INDSOR TOWN OF
ELLINGTON,CT 06 _ IVAN AVE.
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SOP,CT 06074
PHONE 860-875 WA
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WORK DESCRIPTION: CLIFFW O E O FEES
FROM 59 F
THE DRAIN LAYER ASSIGNED TO THIS E 11 �`- LIHE TATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FOR T ` N L SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STAND S F-A I, 3 ATTACHED CONDITIONS.
ISSUED B AT PECTE INSPECTED BY
8/4/2009 3:39 PM
Pcrrol"f 4 9000 4/9
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
o1OO900`7011 TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work:_ Lot #
Street No. Street Name
Premises owned-by: I Ow h o+ S LA
Name of Firm: (;c r 6 e f Corti 4, Jn Phone:5 71 6 6 S-G�
Address of Firm: AJu ime ,�r
TYPE OF WORK:
Lay House Drain • Repair House Drain_
Lay Main : Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with 9/
ExistingWater Supply: Public Water Well
Proposed Start Date 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 G��� 4he holder of Drain
Layer's License No. 127 GeV 2,�_ . 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. 0.)g C t
Signed: A Print Name:-!2or�� h r-
LjcenA Dr in Layer
Date: 7- 31-p 9
Standard F0rms\Pexmits\APPLICA170N FOR DRAIN LAYERS Pt MIT.doc