HomeMy WebLinkAboutdrain layer permit 287 Strong Road 900064 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER 000- DRAIN LAYER PERMIT
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DATE: 11/02/09 "4
GIS ID: 87000287 FEE: 60.00
MUNIS APPLICATION# 200901335 g� EXPIRATION DATE:
12/02/09
APPLICAN = � LOCATION
NAME: JAMES THROWE DB RF7 STRNG ROAD
ADDRESS: 97 RIVERSIDE DRIVE R6NG ROAD LLC
VERNON ROCKVIL 'T �� CR(NG ROAD
JVINDSOR,CT 06074
PHONE 860-289- 0
WORK DESCRIPTION: NEW SE C � #
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THE DRAIN LAYER ASSIGNED TO THIS F ffA V` SS STATE AND HEREBY AGREES TO ALLAl-
THE TERMS AND CONDITIONS SET FORT CH T RK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDA A98ID ATTACHED CONDITIONS.
ISSUED BY DA INSPECTED INSPECTED BY
11/2/2009 2:05 PM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 4 DDC)& Y CONTRACTOR:_'�ra rees
LOCATION: 02 - , Sty-0 j'16
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TYPE OF WORK: kect) _�l!W-oz� CC'`a
DATE INSP NEEDED: DATE INSP: /f
INSPECTED BY: 40
WORK IN
PROGRESS:/_(agi PpIC Sp2 Z� pro
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT. V
INPUT: DATE: � '0
W/2007 Town of South Windsor INPSECRON 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: �r �C Lot #
Street No. Street Name
Premises owned. by:
Name of Firm: Seev,Le-Lk- Phone: -V'5cr)
Address of Firm: G\,'
TYPE OF WORK:
Lay House Drain ; Repair House Drain_
Lay Main : Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with ,x
Existing Water Supply: Public Water Well
Proposed Start Date o Estimated time for completioncd—
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. _ 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. l CC)
Signed: l Print Name._- �~,r /G►��,,.�-L�
(i Licensed Drain Layer
Date:.r�A1)co O r?
standard Forms\Permits\APPLICATION FOR DRAIN LAYERs PERMIT.doc
TOWN OF S0UTH WINDSOR
SANITARY SEWER - LATERAL FIELD LOCATION
DATE OF` CONSTRUCTION:
BUILDING'ADDRESS
STREET ; 5 O N
SUBDIVISION:
NORTH ARROW
G
aY
CONTRACTOR (PRINT NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS r SIG RE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
CCU DATE
TELEPHONE NUMBER
WHITE -`TOWN
PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER