HomeMy WebLinkAboutdrain layer permit 35 Nancy Drive 1000002 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER = DRAIN LAYER PERMIT
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DATE: 01/07/10 rAqof
GIS ID: 62100035 _ FEE: 60.00
MUNIS APPLICATION# 201000011 EXPIRATION DATE: 02/06/10
APPLICAN kLOCATION
NAME: JAMES THROWE DB . V.AN&EY DRIVE
ADDRESS: 97 RIVERSIDE DRIV STINE R
VERNON ROCKVIL m NVAN�6 = s �
DRIVE
INDSOR,CT 06074
PHONE 860-289
WORK DESCRIPTION: REPAIR S I �
THE DRAIN LAYER ASSIGNED TO THIS P t A SH�STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH MITT.CH TI r' RK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARD e 5 TND E ATTACHED CONDITIONS.
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ISSUED BY ATE INSPEC ED INSPECTED BY
1/7/2010 9:59 AM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /00 000 a CONTRACTOR: _-y vre'_S \'-T%ro
LOCATION: 3 A)a o c(A
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: Z/O
INSPECTED BY: g
WORK IN
PROGRESS:
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ 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: /Un2 Lot #
Street No. ttreet Name
Premises owned by:
Name of Firm:_ r+s 5e-LA + A, .-S-fry) 4LC Phone: ??dJ. �GrfI�S'
Address of Firm: 7��r
TYPE OF WORK:
Lay House Drain_ ; Repair House Drain ;
Lay Main------; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with 5c U (1 b
Existing Water Supply: Public Water �C'i Well
Proposed Start Date la � o7 Estimated time for completion AR 17 G 9
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 tom -,
e holder of gain
Layer's License No. z10 ?,g 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. � 5S o II/5-
Signed: Print Name:
Licensed Drain Layer
Date: Qz l > G I
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMrr.doc
�Aolloy, Catherine
From: CallCenter@CBYD2.com
Posted At: Wednesday, December 16, 2009 10:26 AM
Conversation: Locate Request-20095101115
Posted To: CBYD
Subject: Locate Request-20095101115
(CALL BEFORE YOU DIG - CT) 12/16/2009 10:26:02
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-OT 2-SW SWINDS -T5 -W3
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***** EMERGENCY *****
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TIME. .10:25 DATE. .12/16/2009 ` l�
REQUEST NO. . .20095101115
LATITUDE. .41.8086904 LONGITUDE. .-72.5889352
TOWN. . . . . .SOUTH WINDSOR
ADDRESS. . .35
STREET. . . .NANCY DR
NEAREST
CROSS STREET. .DAWN DR
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TYPE OF WORK. . . . .EXC/CUT CONCRETE TO REPAIR SWR -EMERGENCY
AREA IS MARKED. . .YES
REMARKS:
CREW ENROUTE
WORKING UNDER THE FRONT STEPS IN FRONT OF HOUSE
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START DATE. . . . . .12/16/2009 START TIME. .10:15
CALLER. . . . . . . . . .JAMES THROWE
CALL BACK. . . . . . .ANS MACHINE
PHONE #. . . . . . . . .860-871-7968
FAX #. . . . . . . . . . .N/A
ALT. PHONE #. . . .
EMAIL ADDRESS. . .
CONTRACTOR. . . . . .VANS SEWER & SEPTIC SERVICE
ADDRESS. . . . . . . . .97 RIVERSIDE DR
CITY. . . . . . . . . . . .VERNON
STATE. . . . . . . . . . .CT
ZIP. . . . . . . . . . . . .06066
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EXCAVATOR DOING WORK. .SAME
ISSUED TO: DATE: TIME: BY:
DATE/TIME ARRIVED: TIME LEFT: COMPLETED BY:
CALL BACK: 1) DATE: TIME: BY: 2) DATE: TIME: BY:
PERSON CONTACTED: PERSON CONTACTED:
1
TOWN OF -SOUTH WINDSOR
SANITARY SEWER LATERAL . "FIELD . LOCATION
DATE OFm CONSTRUCTION: /on
BUILDING ADDRESS
STREET NANC Y . bfz 1 vE
SUBDIVISION:
NORTH ARROW o°
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CONTRACTOR (PRINT) NAME OF CONTRAC OR SUPERVISOR (PRINT)
27
STREET ADDRESS` / S TURE
C �Lo 1 Z/r�`� DATE
TOWN / STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER