HomeMy WebLinkAboutdrain layer permit 785 Pleasant Valley R Molloy, Catherine
From: CallCenter@CBYD2.com
Posted At: Tuesday, March 31, 2009 10:30 AM
Conversation: Locate Request-20091400973
Posted To: CBYD
Subject: Locate Request-20091400973
(CALL BEFORE YOU DIG - CT) 03/31/2009 10:29:58
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TIME. . 10;29 DATE. .03/31/2009
REQUEST NO. . .20091400973
LATITUDE. .41.8124980 LONGITUDE. .-72.5893771
TOWN. . . . . .SOUTH WINDSOR
ADDRESS. . .785
STREET. . . .PLEASANT VALLEY RD
NEAREST
CROSS STREET. .TUDOR HILL RD
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TYPE OF WORK. . . . .EXC TO SWR CONNECTION
AREA IS MARKED. . .YES
REMARKS:
WORKING FROM ST TO HSE. . .
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START DATE. . . . . .04/03/2009 START TIME. .07:00
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,-- :.SO.UTH ANDSOR
,SANITARY - SEWER LATERAL TIELD '- LOCATION
DATE OF. CONSTRUCTION: Z/
BUILDING ADDRESS : 8
'STREET • L F A .!�A NT �,r/AL L 64 9104-t?
SUBDIVISION:
NORTH ARROW
... 1
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te
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CONTRACTOR (PRINT) NAME Of CONTRACTOR'S PERVISOR (PRINT)
STREET ADDRESS SIGNATU ff
DATE ,
TOWN STATE ZIP INSPECTED BY TOWN
002L DATE
TELEPHONE NUMBER `
WHITE ! TOWN PINK - CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER
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: �5 4A 4 OcJ q_ Lot #
Street No. Street Name
Premises owned by: 4 ✓\
Name of Firm: I/n yl< �r f�j r_ 5''b)re.44 C Phone: S
5
Address of Firm:-
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with 5 3S
Existing Water Supply: Public Water Well
Proposed Start Date Qj Estimated time for completion 4)kQ(7
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 r 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. J VC
Signed: Print Name:
9
Licensed Drain Layer
Date: n L-2
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMrr.doc
r •
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: —110001
. CONTRACTOR:
LOCATION: -7
TYPE OF WORK: ;
---__— DATE INSP NEEDED: DATE INSP: /9-o
INSPECTED BY:�h
WORK IN
PROGRESS: ✓
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AS—BUILT:
INPUT: /l� DATE:
`104
W12007 Town of South Windsor INPSEMON REPORT 07
900011
PERMIT NUMBER TOWN OF SOUTH W I N D S O R, CT
M�,„ �•«< DRAIN LAYER PERMIT
DATE: 04/03/09 `� .,
GIS ID: 72900785
MUNIS APPLICATION# 200900279 •-` 4 FEE:x �* 60.00
' w EXP
APPLICA 3�� 4 ` 4. IRATION DATE: 05/03/09
NAME: I `w 3 € •
JAMES THROWE DIVA• E LOCATION
ADDRESS: 97 RIVERSIDE DRIVE
SANT VALLEY ROAD
VERNON ROCKVII' F '! ..< AUGUSTIN&
;IN .:
" PLEASANT VALLEY
PHONE 860-28 a f T .i ` x .
9'1 00 ,.; r ,; . NDSO R,CT 06074
WORK DESCRIPTION:N. INSTAL E� LAET2A .
THE DRAIN LAYER ASSIGNED TO THIS'I?E .n
s
THE TERMS AND CONDITIONS SET FORTH ,*,sS .• '<
THE TOWN OF SOUTH T "TATE AND HEREBY AGREES TO ALL
WINDSOR STANDA ,>08
IT`I�I ALLY WaRK SHALL BE IN ACCORDANCE WITH
ATTACHED CONDITIONS.
ISSUED BY DA E INSPECTED
4i3i2009 9:17 AM INSPECTED BY