HomeMy WebLinkAboutdrain layer permit 65 Rye Street 1000023 TOWN OF SOUTH WINDSOR CT
PERMIT NUMBER
o \\r
DRAIN LAYER
� �,�� vrvrvvvlvv�\v\vv\� PER
MIT��\11 \
DATE: OS/25/10 \err \\\\
IS ID: 78600065 av4 m�r�mrm,ra,voor, „ream„anrew �,rr� \\
OMUNIS APPLICATION# 201 rrraa�r �A�A� �,,,,rrr armamr„av ,,�� �,hrraer hvrerver�l��\r rws�rr�\���
ar" ee,
000623 ap\ \ \\\er \�\\ FEE: 60.00
EXPIRATION DATE: 06/24/10
VAS p p�� �AAVA\u\\�epmr r err6 � r r� , • r � \
APPLICAN �' ���10 mr `y�r•A\vrrv���\\vverrerr,,;,,rrrer,,,,rrr1\V A�r�
NAME: ENVIRONMENTAL S R�" �.,°"v+ \ CATION
ADDRESS: 90 BROOKFEILD ST
\ a � �
SOUTHWINDSORaaarom ET
ANEELEY REAL ESTATE LLC
PHONE °a�� 11V10� `wrr\\ eve �� \\uu r, rr„rrnrS \BEET
860-528— (0rrmm� \avrgl" Avr� ;rrvr,rvvno\�\w��� °�r�\ \ v� �H� SOP,CT 06074
�V� r r r \ \\",\eNmu \
11
WORK DESCRIPTION: INSTALL vver
r�eA ,A \���, h u wvvA1� vv���vvv����� .uvvnaev�� �p
I�"`Er r urNerrre�rmmAmeWVAVrAA\\\� �A�H� rV�ur��
FOR MAN LESq`V ` a,
r � v�w\C� �'A�` ��eM�� �A e\\�� � �', „am,�rrrrr�°" AAA
THE DRAIN LAYER ASSIGNED TO THIS P ° vvvv1v1 ��
��
THE TERMS AND CONDITIONS SET FORTH A VV , rTATE AND HEREBY AGREES TO ALL
���\ T `ee nr '\fir �RK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS\'
`° �T '\1 euaoeE ATTACHED CONDITIONS.
of �e„�n merr
N1q\a\er �reaeruueererev�ee erer7emermemmmmnru�ommormrrarormuarwr�`
der
ISSUED BY DATE INSPECTED 5/25/2010 3:20 PM INSPECTS BY
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: d bOV dam; CONTRACTOR: O1 V I i�Un`YNe n1�I zs
LOCATION S C-l2 �S-Yee
lly-
TYPE OF WORK: I l a0
DATE INSP NEEDED: DATE INSP: '
INSPECTED BY: d3
WORK IN
PROGRESS: G,, j S a n'4 v
` Nc- S qD(Vc -
w
14
5 �. o1 C,S�, D Tf$
SEPTIC TANK PU D SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
Wj2007 Town of South Windsor INPSEMON 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: 6-7 5 Pit F S Lot#
Street No. Street Name
Premises owned by: Q E MA L
� g Name of Firm: L LtJ1 JIr t S;!-n.U1 6 trlL Phone: b 9 �
Address of Firm: qo
TYPE OF WORK:
Lay House Drain Repair House Drain
Lay Main • Lay Lateral for Commercial/Industrial 6 g4 L(,mAid
Building of acres
Connection will be made with ✓ U C
Existing Water Supply: Public Water Well
Proposed Start Date 1 ) Estimated time for completion 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 toi 1.�A l:r�tR�s f'i older of Drain
Layer's License No. 2 6 2 gi . Only holders of P-1, Poor 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. loin1 "W g
Signed: Print Name: ,c. 4 G 0
'cen r n Layer
Date: f V
Standard Fortrx ermits\APP CATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY - SEWER LATE RA'L' .'.FIE LD LOCATION
DATE OFF CONSTRUCTION: �d
BUILDING ADDRESS
STREET �5 -�
SUBDIVISION:
NORTH ARROW
p
//
F i
1 S .�
jf
(�r1 tilt()#M'+cnl+A( y I C<-- !�C ►c. � p �� CIO u
CONTRACTOR (PRINT)_ NAME OF CO NT TO SUP SQR (PRINT)
aj d 13/L00/c/c, VIP !�
STREET ADDRESS / SIGNATU E
W IAJ(�Sy� V ��d ,� DATE
TOW(N�,[ CSTATE ZAP INSPECTED BY TOWN
�S O J5 g q e� 00 DATE
TELEPHONE NUMBER
WHITE — TOWN PINK - CONTRACTOR YELLOW - CONSULTING .ENGINEER / DEVELOPER