HomeMy WebLinkAboutdrain layer permit 930 Sullivan Avenue TOWN OF SOUTH WINDSOR INSPECTION REPORT r141e_ 5�1
Permit N6. 7386
Location <• 4 Contractor S. J . HOFFMAN CONSTRUCTION LLC
Type Work NEW SAN LAT Address 77 HOFFMAN ROAD
ELLINGTON CT 06029
x 4.rP �e No. (860)8 7 2-8 3 7 5
Date Insp Needed bZ e °
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Time Insp Needed
Inspected By
Work in Progress
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Date
?ermit..No. 7386 Town of South Windsor , CT
Permit- .e 01/28/2002 Drain Layer Permit
Expiration, Date 02/27/2002
Descrip.
Applicant Location
Name S.J . HOFFMAN CONSTRUCTION LLC` , A dr.r. 0939 SULLIVAN AVENUE
Addr. 77 HOFFMAN ROAD Ow
ne THORRE CHERYL MARIE
ELLINGTON CT 06aL
Phone No. (860)872-8375 i
The Drain Layer assl n d t°h1"s r t ''has a �. �d license issued by the
state and hereby agrees. to-'aTJ the ter'rnrs';and cond tions set forth in the
attached 'Conditions' . Al '1 �wor k, s 1 "_in ac�cor ance with Town of South
Windsor standards, all OSHA- requirerfi",t .;" and the attached conditions.
Issued By '9 2r'f ~�
Date Inspected Z O Czq 2- Lnspected By - _--
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPAR11-iEN`f
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Location of proposed work: 9 3 O fi) `//r Lot #
Street No.. Street Name
Premises owned by: CA e r y l �/1 o L:e e
Name of Firm: S��v� j7 W`OL k a 4 k Phone: S G 6 K
1 � JJ
Address of Firm: �� � �( d '� Pd• <<��'hrt�� C f
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with a, n 3-r
Existing Water Supply: Public Water Well
Proposed Start Date �� �' b -� Estimated time for completion
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 �` l� 44 4 the holder of Drain
Layer's License No. Only holders of P1 or P7 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. N JA and/or ConnDOT Permit No.
CBYD No. GcZ
Signed: Print Name:
Licensed DMin Layer
Date:
Standard FormsTermits\APPLIUTION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH
WINDSOR
SANITARY HWER- LATERAL
FIELD LOCATION
DATE OF CONSTRUCTION - O
BUILDING ADDRESS .3 to
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUP ERVISOR (PRINT).
STREET ADDRESS
SIGNATURE
o C�. 06o1
TOWN STATE ZIP Q .dam l�r✓s c— c�1 v �Z- o 0 2., DATE
INSPECTED BY. TOWN
TELEPHONE NUMBER TE
WHITE - TOWN PINK - CONTRACTOR
YELLOW - CONSULTING ENGINEER / DEVELOPER
TOWN ' OP SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER' S PERMIT List Ns•s 2-6010.5NO 141
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 9V Bv=ww Ayeme on the
,Wp*k. side,
at premises owned by F is 00 B lujum, it
whose address is sma
and to Lay House Drain, Repair House Drain, Lay Main, Other ,
for remide"t-t s1 occupancy or use,
with ene U0 Family Units, with tltPP3'OX6 1/2 acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, 3= INDUSTRIAL WASTES, OR
Connection will be made with "IX-400b ( )p aueppe
Permit to be issued to M-3-3brook Mantrictim On- - »rtt-V. Hope
the holder of Drain Layer's License No. w 6.t•3,3 Permit will expire on 19
The undersigned Drain Layer hereby agrees to a-1T the terms and conditions set forth on the rmi a reverse side'"
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection Charge PaidEA.1�/.."9a 177trnsed Drain Layer
3M Attache-4 Sheet a /
(Sig) issued by •
Tax Collector
Permit Fee: Paid $ 3!S.0 1
INSPECTION: Chock Ntmtbert 0,6
INITIAL (Sig)
FINAL (Sig)
APPROVED 4 October. 1922 (Date)
(Sig)
INSAWOk
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NOTES SOUTH WINDSOR POLLUTION CONTROL
Not drawn to scale. LOCATION
D is located approximately
OWNER Franiis 0. Burnham Jr.
6 ft. straight out from TYPE OF WORK Sewer Installation
casement window in base- DATE 10-24-72 PERMIT 141 PIPE6" Plastic
ment, 2nd window from INSTALLER Hoe W9-20 110)
Corner of house. INSPECTOR ME DRAWN BY ME
�ASMSMENTS AND CHARGES
FOR
SANITARY SEWER SERVICE
Town of South Windsor, 1540 Sullivan Avenue 644-2511
• Department of Pollution Control, Vibert Road, South Windsor 289-0185
Occupant Account No.
Address
Owner
Address
Assessor's Location: Lot#. Map Block Parcel
Land Records: Volume Page
Zoning: Use:
Area Acres
't
Sketch
(Not to Scale)
Assessment Computation:
Assessable Footage x Front Foot Assessment $ = $
Number of Laterals x Lateral Assessment $ = $
Total Assessment = $
Assessment Due Date
Deferred Yes No
Caveat Filed Yes No
Paid in Full Yes No
To be paid in installments Yes No
9 Annual Payments of $ plus 5% on unpaid balance
Lien Filed Yes No
Connection Charge Computation:
Number of Units:
(Residential, School, or Church) _ x Unit Connection Charge $ _ $
Number of Acres:
(Other than Res., Sch., or Ch.)_x'Area Connection Charge $; - $
Connection Charge Paid in Full: Date
Collector of Revenue
Assessment & Connection Charge Computations Approved
Town Engineer
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