HomeMy WebLinkAbout12 DRAKE CT LEGEND
ARCHITECTURAL INFORMATION OS IRON PIN TO BE SET
L '•' o MONUMENT TO BE SET
,HAuSE.�TYFaf: :'�:` ; �r .. R�.c�rt
_ -3-09_ _ EXISTING CONTOUR
30o PROPOSED CONTOUR
tUS,E
COLOR 't�,l,�.�ec —w—w— WATER MAIN A.
—G—G— GAS MAIN "
TRIM COLOR 0 04IT! x287.3 PROPOSED SPOT GRADE
ROOF COLOR mt SILT FENCE
NQTE: 3. ALL UTILITIES IN THE ROADWAY ARE TO
`1.1 ROOF LEADERS TO BE DISCHARGED ON BE INSTALLED IN COMPLIANCE WITH THE
SPLASH PADS. APPROVED REDFIELD PLANS. y\\ •z I
2. FOUNDATION LANDSCAPING PER SHEET
L6 OF THE REDFIELD PLANS.
1. SET POSTS AND T. STAPLE THE WE 23` 5 O\P�
ANGLE POSTS EXCAVATE A I'x6' MESH FENCING TO \ 7 J Z Z I
S'UPSLOPE POST UPSL.OPE FROM POSTS FENCINGVARE
DID OF THE POST
FOR SUABILITY
AND SELF- 1
C EANNO
°3 12' MIN. I N aA�.=915 6, 42 sq. ft. I v
0 = 34'12'20" p ti I z
R = 60.00'
TF T = 18.46' A24'36' �o' {`n o Li O
Y._ N 5 z'
(TOTAL) 1 .09' b \ �a
e _ 7
a ATTACH FILTER FABRIC TO 4. BACKFILL THE iuU.'E,5 O=�•` `O cc
FILTER THE MIRE FENCING AND EXTEND TREN04 AND COMPACT TQS•5 CT) O \
FABRIC IT TO THE TRENCH THE EXCAVATED SOIL ' p,f, 99.�1 y 1� Z 3 \
1-8IJ176(dbl)BACIML1 p a in w w
COMPACTED
$
R 60.00. \\ N Z o
5.04 wo.=69.6 /o, W W
005
W
CONSTRUCTION OF SYNTHETIC FILTER BARRIER ` 8. " S 12.
�\
� \
3
i \ 10
1.2 W `�♦ 3
REFERENCE NOTE
BOUNDARY AND TOPOGRAPHIC INFORMATION ARE TAKEN FROM PLANS
ENTITIED 'REDFIELD-SITE PLAN OF DEVELOPMENT', SHEETS 4 THRU 11 O /
OF 30, SCALE 1'-40', LAST REVISION 2/20/92. PREPARED FOR JMJ / CB #75 2
CONSTRUCTION COMPANY, BY DESIGN PROFESSIONALS, INC. pROpO ` /� T•\5.5 /
/ J
ZONE. DESIGNED RESIDENCE / /T'0(i
r / 20' EASEMENT IN FAVOR OF �pAW►+ens�
/ / e�T pF coAJ o,
I HEREBY DECLARE THAT THIS MAP IS SUBSTANTIALLY CORRECT. THIS MAP THE REDFIELD HOMEOWNERS
AND SURVEY WERE PREPARED IN ACCORDANCE WITH THE STANDARDS OF A f./ / ASSOCIATION, INC.
CLASS A-2 SURVEY AS DEFINED IN THE 'RECOMMENDED STANDARDS FOR I x
SURVEYS AND MAPS IN THE STATE OF CONNECTICUT' AS PREPARED AND
22 , ;
ADOPTED BY THE CONNECTICUT ASSOCIATION OF LAND VEYORS, INC., ON
SEPTEMPW3. 1964, CnVE JANUARY 1, 1 CLARK REALTY, INC. ;
658 ELLINGTON ROAD 19 N
i
12882 SOUTH WINDSOR, CT. 06074 _ �:�� f '��¢,�
SURVEYOR'S SIGNATU UC. NO. (203)282-0628 fs ;,�AL NO;'1444
,.tATs 01E SHOWN
Haan.l70 ON ulllllY REVISIONS (203) 291-6755 __ �� ��
SHEET
LOCATION,u allo.Ir ARE OAftD ON Itt!'T � GRAPHIC scALE � ssl�n REDl�"IIIE�.D fU'ILI� l7np�fL15
AVA0.:AlllL L1f'OIIlV111tr ALL ECSToD V1mumm � ^_®e �� 1
SW AD FFOR ATIM PUOR,b OONfiRUOTOi ifQVl
„, L���F To R&D otesslonals, Inc.
OMUMUCflDIa DRAKE OIAAN IM 9M .Cw AKL•ears.,'-u OF
S TNA PLAN 13 DIVMJD UMInS IT YAKS 4E dull en in COURT
IrREssa aEAL Arm COMAL awATUNE 1 inch = 20 feet v v ears • planners a surveyors SOUTH WINDSOR CONNECTICUT a�I sr. AM wrtaa 11
aF iNE M ONAL emmum/simroIL NOC DATE OESCRPACW BY 441 C governors highway, south windsor, connecticut 06074
FEB 16 1993
South Windsor
BUILDING DEPARTMEI�Vr
10 THE &.q.-j C pEPT TUrr,
This certified that thi
coPies s Plon and s! ,
of
greeted at the proPoeod Duudin8 or tlterat,
together with
in
filed
Build Ing anlan andamenI a8rc. to Ceod in aPPlic t+.
iesu d state law. '1:"y with ,
nd such
I zo
his
Perders
rmit, aPP.eat on y the IenA slfna arissuntodurint, PendF-n,;y
/y anp of a building
Signed (—
This ��----� -
Plan )�
aPProve orders antl ordinan d subject to the con
eomptied wl r`Cula t/n dishe thet
ces
th. 8 Du11dIn8 shall Condltlon l»
ally APPro.,�
These NNd with
•uifdin8Plactitif
Ins
Al t�
t;i i t it il.N! IUIV OF ZUNING (.aJirrt'1..h9��s
Proposed bullding(s), use(s) and/or structureks)
as shown on this plan appear(s) to be in
conformance with current South Windsc -
!-egulations. Variances and special exceptions
may apply.
n::—Zoni
Enftoxw.n ent Officer
r
LEGEND
ARCHITECTURAL INFORMATION OS IRON PIN TO BE SET ,?,
HOUSE STYLE R,crrC o MONUMENT TO BE SET ,.. �i \✓�\
SQUARE FOOTAGE - - off- - EXISTING CONTOUR
30o PROPOSED CONTOUR
HOUSE COLOR —w—w— WATER MAIN \
rrA �
TRIM COLOR wN IT& —c—G— GAS MAIN ROOF COLOR \//A
X 287.3 PROPOSED SPOT GRADE \
G�4G� mmm SILT FENCE
NOTE: 3. ALL UTILITIES IN THE ROADWAY ARE TO
1. ROOF LEADERS TO BE DISCHARGED ON BE INSTALLED IN COMPLIANCE WITH THEz
SPLASH PADS. APPROVED REDFIELD PLANS. "y
2. FOUNDATION LANDSCAPING PER SHEET \� I
L6 OF THE REDFIELD PLANS. Ak
9V.
1. SET POSTS AND 2 STAPLE THE WIRE
\ 23
ANGLE POSTS EXCAVATE A e'xe' VARE MESH FENCING TO \ u z z
FOR STABUTY PDST LIPSLOPE FROM POSTS FENCING THE END OF THE POST
AND SELF— 1
CLEANNO.
e5' 12' MIN. N qqt=915 6. 42 sq. ft.
I
A = 34'12'20" p � °v � � ( W K
a R = 60.00'
T = 18.46' I L1 24'36'w '_Vj5 K z, �O x v7.o \ o v0i
(TOTAL) = 13.0.0___r_—G `(m x<
e _
M - �
J. ATTACH FILTER FABRIC TO 4. BACKFILL THE 'r 77 y'� �wV'-BLc �.J, 9B•5 �W
FILTER THE WIRE FENCING AND EXTEND TRENCH AND COMPACT Of p
FAMC IT TO THE TRENCH 114E EXCAVATED SOB.. , F.f q9'l W r-COMPACTED in z_
CB �f76(dbl) t N ���rr Ww \�
BACKFTLL 1 ; '� prO.=OZ•v \ �O' V <O
R
a=
Op• in o
5.041 wv.•p9�� ww
OJ " �OS� 9 I v7e OW
x
CONSTRUCTION OF SYNTHETIC FILTER BARRIER O'12"w\
S361C,12n ♦4` 3
REFERENCE NOTE: I /1_W /`�� , C) �tl�
BOUNDARY AND TOPOGRAPHIC INFORMATION ARE TAKEN FROM PLANS / �� ` /
ENTITLED 'REDFIELD—SITE PLAN OF DEVELOPMENT', SHEETS 4 THRU 11
OF 30. SCALE 1'-40', LAST REVISION 2/20/92. PREPARED FOR JMJ ,d/ / J CB #75 2
CONSTRUCTION COMPANY, BY DESIGN PROFESSIONALS. INC. ci pR pD
O \/
ZONE DESIGNED RESIDENCE l / yOIJ %
Sic
20' EASEMENT IN FAVOR OF ,�tr.r;rrrrirJ�s
I HEREBY DECLARE THAT THIS MAP IS SUBSTANTIALLY CORRECT. THIS MAP / THE REDFIELD HOMEOWNERS
...A "1 .F
AND SURVEY WERE PREPARED IN ACCORDANCE MATH THE STANDARDS OF A ASSOCIATION, INC.
CLASS A-2 SURVEY AS DEFINED IN THE 'RECOMMENDED STANDARDS FOR
SURVEYS AND MAPS IN THE STATE OF CONNECTICUT' AS PREPARED AND
ADOPTED BY THE CONNECTICUT ASSOCIATION OF LAND SURVEYORS, INC., ON L '
CLARK REALTY, INC. o i 63
sEPTEMB 1984,�ANDCT1VE JANUARY 1, 11 7. CL ELLREALT ROAD
12882 SOUTH WINDSOR, CT. 06074
SURVEYOR'S SIGNATURE UC. N0. (203)282-0625 t"
GRAPHIC SCALE REDFUE D SH��
1.UK=ON IMUK NaM EMVW V%M REVISIONS (203 291-8755
AVNL*ea r wl ARE L Do wear PLOT
t3Y1 O T PLAN
M
AVARARE eM'QeIA,KM.ALL�� zo D ,G 20 esign �®,� �®o �� LI�LL, 11 I�L�/K1UV 1
ALL .E W Pe1QI TD eowe,RllcnaL
LAND,e �,O^a° ofesslonals, Inc.
eawsmue mra �]E8�]I�� e�®lU][8'Il" VA4W Or ter. dar ma M IJ.-" °�
„Tee FU,NBY A Is e"MM�IT KAN IM 1
erillnu t TEAL AND aee% aaNAwRE 1 Inch = 20 feet eiVil engineers • planners • surveyors
err IM/ROPEERNOMAL niaNmt/W tWOIL Noa DATE DESCRIPTION 9Y 441C governors highway, south wlndsor, connecticut 06074 SOUTH WINDSOR CONNECTICUT pwam
r
gII�
FEB 16 1993
South Windsor
BUILDING DEPARTMENT
TO THE X&MG DEPT. Towiy GF J 1
Thls certified that this Plan and sP:title tlons ire IrJP
copies nr the proposed building
erected at or alteratians to be
a3 together w
ith amendments Street
}Ited with plan and 1 stated in aPPlic.tlon and
ding agree to complY with all coning,
Issued band st8uild nglaws
Deand such orders as shalt tie
Y the
of this Dartment during Penacncy
Permit. application at flnet issuance of a building
Signed
This Plan is approved
order and olect��itlon --_dinances regulatin that
comPlied with. Q building shall be
conditionally ADDroveq
Jheae tiled with
puilding inspector
CIaA
1
PropoSed buildln OF
as shown or, thi an /or
Sulat,confOronsce with cure structure(s)ar(sl o�ture(s)
May variance be in
current
Date apply. s and special Windsc.
exception,,.
f
orcQmPnt
I -
,I
_ .. _ _-,, - _: r- .. _ ,. 1-.#ram• I �_ _ f t�f'` ai - I '� ��' _ _� _
2'
°
1F
\ r�n n nlT•m�i0� — A .Y`F k.'- , �-,�.:>.eST dA t_.zS
ink
A0 Al
LEGEND �q`� '779
d tRON PIN TO-,BE SET ez.z
o 'MONUMENT TO BE SET 9Z \ r�`E '� B/T ` v� QQ.
x287.3 EXISTING -SROT GRADE E< 4 = 76.58 6, )42 sq. ft.
N Obi✓E o �
_ 300__ EXISTING CONTOUR Lil?
—w—w— WATER MAIN 3 p _ 34*1 U q5.5� io.o
—G—G— GAS MAIN ,,Ails EKVIGE T = 18.46 p 24'36'42" 16.16 /t.o• A L.3b 0cn
R = 60. sb' ,,, U)
L = 35.82' T .09' c F: 98. 3 8 �' 0 a
(TOTAL) a i 74 cn
NOTE: .. SHE/ ►8 L = 5.77' ��. T.O.W.=97.36 r7 m Q Cf)
1. SANITARY SEWER INVERT ELEVATIONS TAKEN FROM 5.�' "wv: 88.5 :1- LL, L`I
-INSPECTION REPORT PROVIDED BY CONTRACTOR. ul ti CD Z
2. ALL ITEMS DEPICTEID-09 THIS PLAN HAVE BEEN A11 �T Iv LAIO
VERIFIED IN THE FIELD AS TO LOCATION, ELEVATION CB #76(dbl) I W in +Z< oV[��r tiq L)W
AND COMPLETENESS. ;O 1mv = 8Z �� �'iB \� Z Q00 98
p�X'IX`W 78 pca/ 8 8 a.Z o
v ° \ (4 S aLAJ w
J \ 3-'s s -
9z DS 9E. ; 96.5 6 00
IAj
V 36.
8876 �08q,
'� m RAD \ x9S.68
REFERENCE NOTE:
BOUNDARY AND TOPOGRAPHIC INFORMATION ARE TAKEN FROM PLANS =' ` tl
ENTITLED 'REDRELD—SITE PLAN OF DEVELOPMENT', SHEETS 4 THRU 11 `� �y , 99 9 eo f
OF 30, SCALE 1'-40', LAST REVISION 2/20/92. PREPARED FOR JMJ
CONSTRUCTION COMPANY, BY DESIGN PROFESSIONALS, INC. r nd TB.- S S7
ZONE: DESIGNED RESIDENCE `
t
THIS MAP AND SURVEY WERE PREPARED IN ACCORDANCE TO A-2 ` ' n
�; , ; � 20' EASEMENT IN FAVOR OF
STANDARDS OF HORIZONTAL ACCURACY AS DEFINED IN THE t THE REDFIELD HOMEOWNERS ---'
RECOMMENDED STANDARDS FOR SURVEYS AND MAPS IN THE STATE ba y `- g� ASSOCIATION, INC.
OF CONNECTICUT' PREPARED AND ADOPTED BY THE CONNECTICUT1114
96
ASSOCIATION OF LAND SURVEYORS, INC., SEPTEMBER 24, 1992. 'All
TO THE BEST'OF MY KNOWI EDWAND BELIEF THIS MAP IS r f ,4
SUBST T REC kD
t 'die
TED HEREON.
i �
12882
RICHARD P. MARTEL LIC. No. ~tiY °+ t Lr,. a • lie, c Ypl may.
- ,Tz+.y;> °���+td-ice"•`
, UPII-M OTHCRVIM NOTED. EJDS'TNo UTILITY REVISIONS GRAPHIC SCALE (203) 291-9755 RI`DI'¶T�y LD SHEET
LOCATxMS AS SM01M AM BASED ON BF3'T lL u tL AT P/A M
AVAILABLE NEORMATIOI. ALL E74SDN0 UIWIT-5 20 0 10 20 esign (��'f
24OULD BE FIELD YERfrED PRIOR TO CONS-MUCTX*L rofesstonais, Inc. LOT No. 23 1
T ALL UmTIES ARE TO BE STAKED N THE FIELD n �}•. OF
BY A LICENSEDCTIM LAND SURVEYOR PRIOR TO -- �� p\ IM COURT
! A IE ORAMv B/ 9iY pB N0. AI/f N2J
CONSTtOS�W.AN IS NVALID UWEFSS IT K-ARS T�4E • r_ivil engineers • plonners • surveyors
NPRESSION SEAL AND OTJWAL SIONATUR¢ 1 inch = 20 feet 93
Or THE PROFESSIONAL ENONEP]L/%MVEvai NO. DATE DESCRIP110N BY 441C govemors highwoy, south windsor, connect!" 08074 SOUTH WINDSOR CONNECTICUT afacm Br. wu O�IE
JUN 9 1993
South Windsor
{ BUILDING DEPARTMENT
:e
w rNe o":t .<�' ,t �at�t wf
Tn1a cartMWti that.tn�s Wan and sped(
tteDYeead. Ou ta�Rtons are t�
,r enacted aattha art er altsratrona to .
�dithar tetM amend Strawryas Ole stateY ;;WIlation
d Wad.with plan and I Game to cowrpi� .r and
ttultpn` and state. taws and such .�7:rs "Wins
rWad by Me 3u. a',ali be
VOing urpartment ounn4 Fi'n0-1cy
"' w -M this appNca Moe+aPd Unai isse
♦armit, a"'v W • bu4aline
_ .MM► �.ysrt,,,�,Q-eyltee*.20 a, ""aii, that
� r Y4tR� •ills
S shell tle
.' .�� � � n/ aaMaetM►�wMn.M.. Trr�r 1'
<< �.,.�,w ,•o,a,«.,
RECEIVED
cww*
JUN J 9 1993 P. 4D
Tatra of South Winds'r
F Engineering S
� 6 wept.
,b
06
a Dr
OF 1—;Qt.'T.H WIN— .##Qp ....
�NEERR\CD IMPARTbt�
I
E
• 24
\ 76 X qb 3 ib 51
wW
LEGEND \ 50�.515z `
',zz8 Jzrfl, 2•
os IRON PIN TO BE SET 9�► zz.z' `\, _
o MONUMENT TO BE SET =r AW.
X 287.3 EXISTING SPOT GRADE E�E� '``E B� T o = 76.58 6, 42 sq. ft.
_ 300 EXISTING CONTOUR 1P O��✓E o
z
—w—w— WATER MAIN Z� = 34'1 -
-G—G— GAS MAIN ; ;EaJlc£ - .00' /o o 1
e- T = 18.46' � 24'36'42" �b i6 x`+b 36
2.0 � O
L = 35.82' R = 60. ` gib. L_ O 1n
(TOTAL) q,.�a T .09, <<= 7d.38 °' m o<
NOTE:SANITARY SEWER INVERT ELEVATIONS TAKEN FROM SMN a 8 L = 5.77' 1q,- T.O.W.=97 36 s.b M > LO
1.INSPECTION REPORT PROVIDED BY CONTRACTOR. <.q I^I✓•- 8B.5 tL w
ON THIS PLAN HAVE BEEN pNt. �T W N UI O\
VERIFIED IN THE FIELD AS TO LOCATION, ELEVATION 5 CB #76(dbl) �~ t` Z 3
2. ALL ITEMS DEPICTED
AND COMPLETENESS. ;p ,v _ 8z.o 9'9B w �Z` Q p 98
RS Q p ,N z
a-np0 �B ca
N (21
,p
_
p0. w w
. 05. 5
J 84, s S5
�z � \ 3 0 9 6, b O n
O - — <,e:✓ �E o \ v .bbw we��s
3
108
R \'2 W x 75.e is
S38 7p'1 \ 3
REFERENCE NOTE: 47 2"W
BOUNDARY AND TOPOGRAPHIC INFORMATION ARE TAKEN FROM PLANS ?
ENTITLED 'REDFIELD-SITE PLAN OF DEVELOPMENT', SHEETS 4 THRU 11 t 99 �SZQ S (z
OF 30, SCALE 1'-40'. LAST REVISION 2/20/92. PREPARED FOR JMJ O
CONSTRUCTION COMPANY, BY DESIGN PROFESSIONALS, INC. / CB #75 2
J/ -f.L.-ySS7
ZONE: DESIGNED RESIDENCE
THIS MAP AND SURVEY WERE PREPARED IN ACCORDANCE TO A-2 20' E \ �!
STANDARDS OF HORIZONTAL ACCURACY AS DEFINED IN TH EASEMENT IN FAVOR OF
THE 20'
EASE EN HOMEOWNERS —
'RECOMMENDED STANDARDS FOR SURVEYS AND MAPS IN THE STATE ASSOCIATION, INC.
OF CONNECTICUT' PREPARED AND ADOPTED BY THE CONNECTICUT 96
ASSOCIATION OF LAND SURVEYORS, INC., SEPTEMBER 24. 1992.
TO THE LL
ST OF MY KNO GE BELIEF THIS MAP IS 22
SUBST J AY CORREC A HEREON. _-
Z 12882
RICHARD P. MARTEL UC. No.
L uNLES!S o.9 SHOWN
AMWOTED,B ocsnNc IEST REVISIONS GRAPHIC SCALE : (203) 291-8755 �IEDIFRIETj D
1L �( PLAN SHEET
ANCAnous 0s RMATI ern Nu LMU 20 D 10 20 es'9n
SHOULDIE R&D YERFI ALL OR TN0 DNS-MU ®� ®G ��
s~NvLN 11 Fl�N �v1eaR TO�HE FIELD -- - rofessionals, Inc. 1
z �u ununa ARe To ee sr�n a 1H[ Flao
BY A LIf.'4)/SET LAND SURVEYOR VWOR TO ����� ®��� OF
I IRIS UCnQI DOMW Br me XJe No- mini-IJ
1 1N5 V1-AN is INVALID uuiFss IT errRs THE civil en ineers • Tanners • surveyors
ors - -
sa>REsvNH �,.,wo oRwak swuAn� 1 inch = 20 feet g P y — �----
Nr 1�F.OF ON cHaerm�ImAry loR LN0.
DATE DESCRIP170M BY 441 c governors highway, south windsor. Connecticut 06074 SOUTH WINDSOR CONNECTICUT aEmm a a, Ae;B v93
JUN 91443
South Windsor
BUILDING DEPARTMENT
pp W �,.•li .1. _tpT. TowN OF SOUTH 111"S44
TW elp �Nied th,t this plan and specifications are trW
Sep," of tM gopo"d budding or alterations to big
^ f t),,aak�
Strnet
j I h afwundmeoft Md" in jppllcation n4
filed with plan and 1 to cophiply with all zoning,
SuitdIng and State laws and such ordrrs as shnil be
yet faaued by the Bulldlni1 Dep;irtment during Prnde—V
of this apoication and final issuance of a bubdin'
permit.
S iSned
Thia Pian is approved sublect to the condltlow
ry ordere awd Ordifam"s regulating bulidlnd shall qa
compiled with.
Condtttgnatli. AppMved The" tNrd MIItN
C Fos
`�•�;;'_ Suiidlnd It1d0gIS1
r`4 V Date -
�� RECEIVED
JUN �i � 1993 � 4
OI of South Windsor
Engineering
6 Uepr p p R O v ED
T 1N O r
ryr;,at V E
ER1''d OEPARTMU4T
o- y
,iZ
4t
/'�_ .w�����.�..,-_..._..
S V I •■ �N ED
l ,
DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT
TOWN OF SOUTH WINDSOR PERMIT#((,,
Application is hereby: Q � D
BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUEsll Bldg.Permit#
Q Z Jim 644-2511 ext. 230 a
date' Building Inspector
Application must be printed or typed
Location of Job:
FEE SCHEDULE
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT = e l L ()
APPLICANT ADDRESS Ls.LNa
APPLICANT PHONE#
O W N S F OWNER U -�
'� q< OWNER ADDRESS
r; OWNER PHONE l -a)
C ESTIMATED COST$
IS THIS A CONTRACT COST? o Yes _No
FEE ENCLOSED$
TYPE OF JOB:
SOR CO��
New Installation
Alteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR PLUMBING PERMIT (continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
RESIDENTIAL BUILDING PERMIT APPLICATION? ❑ YES fNO
BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑ MERCANTILE FUTURE USE AND OCCUPANCY
❑ EDUCATIONAL
❑ INSTITUTIONAL
❑ FACTORY ENGINEER'S NAME PHONE
❑ STORAGE
❑ GARAGE ADDRESS
❑ MIXED USE
CITY STATE ZIP
(Other please specify)
TYPE OF INSTALLATION SIZE OF MAIN DRAIN
NO. OF TOILETS STYLE NO.URINALS STYLE
NO. OF BATHTUBS NO.OF SHOWERS NO.OF LAVATORIES
NO. OF CONDUCTORS SIZE NO.OF STACKS SIZE
AREA OF ROOF NO.OF CATCH BASINS NO.OF FLOOR DRAINS
NO. OF OTHER FIXTURES KIND
ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW ❑YES ❑NO
SIZE OF WINDOW IF NONE C.F.M.OF VENTILATOR
SIZE OF DUCTS SEWER OR SEPTIC TANK
SIZE OF WATER MAIN SIZE OF WATER PIPING&RISER
WATER HEATER: TYPE MANUFACTURER
DESCRIPTION OF WORK
FHE UNDERS1UNED HEREBY APPLIES FOR A PERM-1 I Pro PERFoRMTHE WORK DESCRIBED AND 1977—
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
2 V 3 j 5 �
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE 2 O 2