HomeMy WebLinkAboutDrain Layers Permit 0126 Avery Street 900056 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 09/22/09
GIS ID: 077 '
MUNIS APPLICATION# 200901141 sr FEE: 60.00
XPIRATION DAT
E: 10 /09
E /22
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APPLICANT =t LOCATION
NAME: SKIPS SEPTIC xA,r ys �$ � AVERY STREET
ADDRESS: 27 MUDDY BROOK IU D MA,ENTERPRISES LLC
ELLINGTON,CT OCR I I(0 LO1ISIANAST
PHONE
8 6 0-8 7 J 2332
MR?;
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WORK DESCRIPTION: NEW SE)A' C1 � J J E I s� j 'y {ns R
THE DRAIN LAYER ASSIGNED TO THIS'FERMI'I MA.A VL I ISSjT D B THE`STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTS IN SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS;EYI L OSIIA R (IIIRE�1lfNT , 1ND 1H$ATTACHED CONDITIONS.
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ISSUED BY DATE_ INSPECTED INSPECTED BY
9/22/2009 3:20 PM
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INSPECTED BY:
WORK IN
PROGRESS:
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED [KYES ❑ NO
AS-BUILT:
INPUT: DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE.
SOUTH WINDSOR, CT-
FEE $60.00
Location of proposed work:_ !Z� fy�' zY Lot #
Street No. Street Name � �
Premises owned by: 07Z&-c E q pa 6 E,�-
Name of Firm: SF P-17C Phone:
Address of Firm: a • eox "4 6'7?
TYPE OF WORK:
Lay House Drain_ ; Repair House Drain_
Lay Main-------; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water Well
Proposed Start Date q z S 0 t' Estimated time for completion 9-2�"o
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to the holder of Drain
Layer's License No. 20 17 ?2 S Only holders of P-1, P-7 or W-9 licenses
will be.issued a permit. 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 attached thereto. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT.Permit No.
CBYD No. 00 9 J ?0
Sign �4ZPrint Name:_7�77 4JG
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY.- SEWER LATERAL FIELD -LOCATION
DATE OF CONSTRUCTION: l2.,Z��
BUILDING ADDRESS ' C M4dolca�rel.- -C�_
STREET
SUBDIVISION:
NORTH ARROW.
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CONTRACTOR (PRINT) NAME OF CO RACTOR' SUPERVISOR (PRINT)
,die.
STREET ADDRESS- SIGNATUR
II /07 ?<�/` DATE
TOWN —v' STATE
ZIP INSPECTED BY TOWN
7 S Z31 L ` DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER