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HomeMy WebLinkAbout3 Copper Ridge Drain layer 900066 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 11/13/09 GIS ID:23500003 FEE: 60.00 MUNIS APPLICATION# 200901396 � EXPIRATION DATE: 12/13/09 APPLICAN _ " � LOCATION NAME: J&H SLATER CONS QWi va " OPP RIDGE ADDRESS: 75 COMMERCE WA � CO INC SOUTH WINDSOR, �fE&L' GTON RD - SOR,CT 06074 PHONE 860-528- 2 � WORK DESCRIPTION: NEW SE THE DRAIN LAYER ASSIGNED TO THIS P a5 STATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FORT _ �ACII T. : RK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDARD L 1 ATTACHED CONDITIONS. ISSUED BY., ObATE INSPECTED INSPECTED BY 11/13/2009 12:55 PM Z. Al y- - wt>� Alf t TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: 00©6 G CONTRACTOR: C2 LOCATION: TYPE OF WORK: / I�/eJ 'it�- - C o h✓� ✓O✓1 DATE INSP NEEDED: DATE INSP:- / 116�0 9 INSPECTED BY: Rb WORK IN PROGRESS:�_L'c_ a �� 3 S.�� r ��9��� �VG 5 D/Z a tr �'� C✓cam I S atS 100, SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: c U" DATE: I► 1 - 0 I W/2007 Town of South Windsor INPSEMON REPORT 07 9 0006 r 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:_ Lot # K Street No. Street Name Premises owned by: �C_ C Name of Firm:_ Phone: "� 2- Address of Firm: �y 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 kl l.o 6 Estimated time for completion 2 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. -ZSs-T-7�6 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 S eet Excavation Permit No. and/or ConnDOT Permit No. P14WN CBYD No. Cq Z2..�� Sign Print Name: ✓ 'Z-- Ucensed Drain Layer Date: d/�f 3�6 J Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc ■ ■ ■ ■ ■ ■ ■ ■ ■■■ ►. e i 1 1 i /