HomeMy WebLinkAbout1675 MAIN ST (15) DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
PERMIT#
TOWN OF SOUTH WINDSOR
Applicatio 0 0
BUILDING DEPARTMENT —
APPROVE 1540 SULLIVAN AVENUE
j� 644-2511 ext. 230 rN
Bldg.Permit#
ate El9guilding Inspect
Application must be printed or typed
FEE SCHEDULE Location of Job:
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000= .��'��
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT
APPLICANT ADDRESS
APPLICANT PHONE# G.— j j 8 3
0 W N g F,q OWNER k04_.,,
F < OWNER ADDRESS 7
5, w
OWNER PHONE 0�20 &,3 fD
C z ESTIMATED COST$ 00
� V
IS THIS A CONTRACT COST? _ es —No
FEE ENCLOSED
TYPE OF JOB:CO
_New Installation
Alteration/Addition/Repair
Revised 4/01//2002