HomeMy WebLinkAbout111 Concord RoadElectric# APPLICATION FOR BUILDING PERMIT
Plumbing# 111 CONCORD ROAD (R0 01)
HVAC # T
22549
Date: til tf-
Sprinkler#
FINAL APPROVALS Estimated Cost $ C S
Building 1 f COMPLETE RED BOXED AREAS Permit Fee GQ
Engineering S TYPE OR PRINT ONLY Occupancy Fee $AffidavitAffi
for CO. SIGN ON REVERSE SIDE
Total Fee U
TO BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR,CT Additional Cost) $
Th undersigned hereby applies to do work accordin o the fo owing specifications:
Job Location DU Lot No. Side of Street Zone
Applicant Tel. # j'' Y•.f9
Address /O TIA R N 13 L4 L L "RDA b AlAHC*5)t . 'p Ob00 Lic. #
Owner T y• Address ®dip
Architect Address-
Sq. Ft.New Area: Ist FI. 2nd A. 3rd FI. Total New Area
Rooms Lavatories Bathrooms Garages
Purpose of this permit:lC'jaP,N ram
City Water C Well Septic System Sewer 2
Use Group Construction Type Area Basement Garage
Approved by Date
Revsed 6/95
I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of
South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this
permit is asked, and agree that this building is to be located the proper distance from all street lines,side yard lines and required
distances from all other zones and is located in a zo i whic this - ing n
4ilsse
is all wed.
Signed --
I hereby apply for a Certificate of Occupancy for the work described in this application for the permit
Signed
DO NOT WRITE BELOW THIS LINE --
INSPECTION COMMENTS