HomeMy WebLinkAboutDrain Layers Permit Peachbrooke TOWN OF SOUTH WINDSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT
19
Pursuant to written application, permission is hereby granted tp the Licensed Drain Layer
named herein to perform the work indicated below at t%a (-)-I
at premises owned by l3r t �--t whose address is
Lay House Drain, and to Repair House Drain, Lay Main, tr''
for Other Family Units, with acres. occupancy or use, with
Type of Sewage to be connected under this permit: SANITARY SEWAGE (1r), INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
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_r
SPECIAL CONDITIONS !��'� ' ! yC6 7
Desired Starting Date j- -4' Estimated Time for Completion 7
ab0LU �
Permit to be issued to c,: C�, j F r , E' =-�t �»roc r
the holder of Drain Layer's License No. 2,'L(� y 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 the reverse side thereof. Applicant has received
Town Permit No. and/or CHD Permit No.
rl
Signedrz` E
censed Drain Layer
The above named Drain Layer has a valid license issued by the State of Connecticut and
has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor:
AJ
Engineering bepartment �. +� Date
Connection Charge Paid Permit Fee: Paid $
Check Number
Issued by
Tax office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date
or
TOWN I-- ROU1 t Nv. PMT.2B-REV 10i87
SOUtrl Wi.ndSOr 1 9Z DEPARTMENT OF TRANSPORTATION August 1 , 991
BUREAU OF HIGHWAYS
NAME OF HIGHWAY STATE OF CONNECTICUT DATE EFFECTIVE j � !/rj (� � 8(�
Route 194 PERMIT - II ``Jt
LOCATION OF WORK,OR BEGINNING AND ENDING POINTS: DATE OF EXPIRATION AMT.OF SURETY BOND
Su7_.;_i van !avenue August I lqq_'L
CERTIFIED CHECK
SURETY COMPANY/BANK
Brom Bu:i.l_ders Inc.
BOND NUMBER
TO
Brom Bui-l.ders, Inc. 6Q 48932-2 —
207 West 'Town Street SIGNED
IS VOID UNTIL YELLOW COPY IS
SIGNED AND RETURNED TO THIS OFFICE.
Norwich, CT 06360 PLEASE RETURN AT ONCE.
FEE: DATE REC'D.:
L J 100.00
Permission is hereby granted to do the following work under the supervision of the Department of Transportation, Bureau of Highways
at the location designated hereon, subject to the statements made on the application for permit, and to the pertinent provisions of the
current permittee manual, including amendments thereto.
This permit does not become effective until all necessary local and State licenses and permits are obtained by the Permittee or his
1 agent,and further, the Permittee shall be subject to all Federal, State and local regulations_
This permit is issued in strict compliance with, but not limited by, the following specific requirements, referenced attachments and the
current edition of the Bureau of.Highways Standard Specification as are ap licable
The Bureau of Highways Permit Inspector George Johnson musT BE NOTIFIED AND THE
CALL BEFORE YOU DIG REQUEST NUMBER RECORDED 48 HOURS IN ADVANCE OF STARTING
WORD ON THE PROJECT. REQUEST NO.
B cavato withing the hic-r,<,ay right-of--way to construct and pave a new
roadway, a '.eft turn by-pass area, install_ 0.ra.%Ilag3, utilities, s_'.dewal_Rs
and C..,a necessary Landscaping as de l_ineated oil p3-ans entit?.ed "Peai:,h 3. ,ol.C'
Zon 7i_�4tr_1.ct D tZ App.I.J.cant ;from Buil.de-rs, Inc. 207 West 1.o.:n St. Na:vJ-,Ci1,
Connect'-cut, Property Of Norman P. Priest Su)_]J.van Avenue -- told!. Rout::. 194
South Windsor Connecticut, dated March 13, 1991 _i.aSt revised 7-23-91 a-11 of
wlli-ch shc_••'..1. be in zicCordance with the current General_ and Construction
i2eGU?.?=:3rili?ntS date4' JanUc'.trV 19GU, attache Q, ."i:.1Ys'
1 . No work, that wi_l.l interfere with the f.l_ow of Route 194 trafz,_c
wii..l_ be permitted before 8:30 a.m. and after 4:00 p.m. , Monday
thru Friday.
2. One ( 1 ) uni.formed. traffic person w:Ll_1_ be recluzrad for the above
wo-:C-
3. Traffic .control, perso�inel., should .fami_ iari_ze. themse1yes w:s_th the
attached traffic control, patterns and the attached guide enti_t .ed
"Control_ .oi:- Traffi_c through. Wowl:areas". -Stop/.Sl-ow ,padd ;.es, are. ,
roconmiended.
4. Instal.). Stop Sign and Stop Bar with a centerline DO NOT paint a two
.'•..ane Exit.
— CONTINUED —
ALL before you DIG! TOLL FREE, STATEWIDE 1-800-922-4455
Any and all liability for injury,damage or loss resulting from such work as maybe undertaken under the terms of this permit is assumed by the Per-
mittee.The Permittee is hereby designated responsible for all future maintenance of all installations or encroachments constructed under this
Permit,which in the sole judgement of the State are not part of the highway appurtenances normally maintained by the State.
Permittee hereby agrees to indemnify and hold harmless the State of Connecticut for any and all such injury,damage,or loss that maybe incurred,
either directly,as a result of said work,and to reimburse the Department of Transportation for any expenses incurred due to the performance of
any such work undertaken under the terms of this permit.
This permit is revokable at the discretion of the Transportation Commissioner or his designated representative. GAP/jg d,
,
PERMITTEE'S SIGNATURE DATE DEPARTMENT OF TRANSPORTATION
I BUREAU OF HIGHWAYS,.%
..........
l� L2, BY Robert J. Mongi7Jo
DISTRICT MAINTENANCE MANAGER
� h
1-117988
� :OM BUILDERS, INC.
207 WEST TOWN STREET
NORWICH, CT 06360
S. Sufficient fill should be provided on the West Side of Route 194 where
the widening is to be constructed to match the existing grade.
6. Drainage should be functioning during construction.
7. A Right to Drain to the State of Connecticut is required.
8. The Drainage Connection Concurrence that accompanies this permit must
be completed in accordance with the Drainage Concurrence Attachment
which is also provided herewith. tis requirement must be satisfied
before this permit can be considered complete.
9-. Detention Basins. When site drainage proposals include detention
basins the permit should contain the following to protect the
State: "The owner(s) of the property containing the detention
basin agree(s) to maintain this basin and associate drainage appur-
tenances so that no damage occurs to State drainage systems.
The owner or his successors, in interest, agree to save the State
harmless from any and all claims which may arise due to the
operation of this basin or associated drainage apputenances."
The permit should be recorded in the Town land records at no cost
to the State. In some cases, where it is deemed necessary by the
District Drainage Engineer an Encroachment Agreement between the
property owner(s) and the Department should be executed and re-
corded in a manner prescribed by the latest procedure.