HomeMy WebLinkAbout1979 ELLINGTON RD Electric # APPLICATION FOR BUILDING PERMIT
Plumbing# 1979 Ellington Rodd
HVAC# FDate: —
Sprinkler# 900530 Estimated Cost $ d
FINAL APPROVALS Permit Fee $ !.S --
Building COMPLETE RED BOXED AREAS
Engineering TYPE OF PRINT ONLY Fee $ /o
En nsp. Fee $
Affidavit ► t SIGN ON REVERSE SIDE
Appr.forCO. _ Total Fee $
TO THE BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT (Additional Cost) $
The undersigned hereby applies to do work according to the following:
Applicant & _//h�� Locatiion fWork Lot No.
Applicant's Address t 7 L�!-L A + Tel # W 5 7
Town s W wA OSb Zip Lic.#
Owner Architect _
Owner's Address 9 7 1 Architect's Address
S - W Zip ��RR
Sq. Ft. New Area: 1 st Ft. 2nd FI. d FI. n Tota1W r
Purpose of this permit ��Th-�A„ e. U� 4A. _ 6
C
City Water❑ Well 0 Septic System ❑ Sewer❑
Ins: HO SP Cert. Area Basement Garage
Approved by Date Z�'V Use Group — Construction Type
Revised 1108 14 ;(
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 which this building an
its use is allowed.
CSigned
erl:ficateI hereby apply for of Occupancy for the work scribed in this application for the permit.
Signed
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
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