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HomeMy WebLinkAbout25 Skyline Dr - Permit & Tie Card;yeuC 061 n R74 Permit Number: EDL-23-10 Application Date: April 17, 2023 Applicant Town of South Windsor Engineering Department Drain Layer Permit Base Permit Fee: $80 Expiration Date: May 18, 2023 Location Contractor Name: Kenneth Ouellette Contractor Address: 180 west newberry rd 180 west newberry rd Property Owner: steve ferrabelo bloomfeld, connecticut 06002 Location of Work: 25 skyline dr Skyline dr Phone: Email Address: 860 982 8528 incorpind@ Type of Property: Residential Type of Work: Sanitary Sewer Repair Date work will start: April 25, 2023 Description of Materials to be used: 6 inch pvc sdr 35 replace exusting Valid From: April 25, 2023 Expires on: May 18, 2023 � /,I, �VW6- Jeffrey Doolittle, P.E., Town Engineer April 25, 2023 Date Signed Applicant agrees to furnish the Town of South Windsor the amount of bond required and to reimburse the Town of South Windsor for any expenses incurred by the Town for repair or maintenance work done in connection with this permit. The Contractor assigned to this permit has a valid Drain Layers License issued by the Slate of Connecticut and hereby agrees to abide by all the terms, conditions, rules and regulations of permits as outlined in the Town of South Windsor's Ordinance, Drain Layers Permit Manual, Public Improvement Specifications, Stale and Federal OSHA requirements and any other applicable conditions. TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS : STREET : SUBDIVISION: 2 -i----t---�--- -PA i I I ;- - -- T- --' I- i - ; --�- --� -� -- -� --- --,-a- CONTRACTOR (PRINT) �J dA 00CI I !e- yyf 9 if STREET ADDRESS 06 TOWN STATE ZIP TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER IV) VK Erke fi pC�x P� nr9C�c�l, c�