HomeMy WebLinkAboutdrain layer permit 25 Glenwood Road 1000054 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 10/14/10
GIS ID: 35700025 FEE: 60.00
MUNIS APPLICATION# 201001406 EXPIRATION DATE: 11/13/10
APPLICANT LOCATION
NAME: STI ASSOCIATES,INC.DAY:INC ADDRESS 25,GLENWOOD ROAD
ADDRESS: P O BOX 797 OWNER: MpRRIS HENRY EST OF&JOYCE F
VERNON ROCKVILLE;CT 06Q56- 25 GLENWOOD ROAD
SOUTH-WINDSOR,CT 06074
PHONE 508-943 4,104` >
WORK DESCRIPTION: NEW SEWER CONNECTION
THE DRAIN LAYER ASSIGNED TO THIS PERMIT HAS A VALID LICENSE ISSUED BY THE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH IN THE ATTACHED`CONDITIONS'.'ALT,W01tK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,ALI OSHA REQUZ�2E . .. AND THE ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
10/14/2010 2:57 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 10000S CONTRACTOR:
LOCATION: _� S ,�le n L,2,20
TYPE OF WORK: lVec4) SP-(2)
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: 8-1t)
WORK IN
PROGRESS: Con iv%j-l1QA Ce . Puc_ S47,sb
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SEPTICTANK PUMPED, SMASHED, FILLED WITNESSED YES ❑ NO
AS-BUILT:
INPUT: DATE: 0
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
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: -C-T/ d U a.� Lot # 9 L
Street No. Street Name
Premises owned by: u r* 4,� AT,`k A
Name of Firm: S r i AS b� . Phone: s k 91/3 110,y
Address of Firm: V/
TYPE OF WORK:
Lay House Drain A: Repair House Drain ;
Lay Main : Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with S i) 11 3 s
Existing Water Supply: Public Water A Well
Proposed Start Date t L rt�to Estimated time for completion .3 cis
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 _1-: ( R -lost 5 TI A 5s, the holder of Drain
Layer's Ucense 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 terns
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. 013 Y
Signed:_ C I—etfi Print Name- t `1 dos t
Licensed brain Layer
Date: . 10 113 l lu
Standard FOrn'S PermitsWPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: l o ligho
BUILDING ADDRESS
STREET
SUBDIVISION:
NORTH RROW
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CONTRACTOR (PRINT): NAME OF CONTRACTOR S SUPERVISOR (PRINT)
STREET ADDRESS SI NATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN r
0a DATE
TELEPHONE NUMBER
WHITE - 'TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
Molloy, Catherine
From: CallCenter@CBYD2.com
Posted At: Tuesday, October 12, 2010 11:19 AM
Conversation: Locate Request-20104200738
Posted To: CBYD
Subject: Locate Request-20104200738
(CALL BEFORE YOU DIG - CT) 10/12/2010 11:19:08
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-GV -OT 4-SW SWINDS -T5
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***** ROUTINE ***** si
f
TIME. .11:18 DATE. . 10/12/2010 ry
REQUEST NO. . .20104200738
LATITUDE. .41.8259700 LONGITUDE. .-72.5209764
TOWN. . . . . .SOUTH WINDSOR
ADDRESS. . .25
STREET. . . .GLENWOOD RD
NEAREST
CROSS STREET. .AVERY ST
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TYPE OF WORK. . . . .EXC TO CONNECT SWR LINE
AREA IS MARKED. . .YES
REMARKS:
WORKING IN THE GRASS AREA BETWEEN CL&P 21350 LC ACROSS THE ST FROM THE PROP & GNG CL&P
21351 LC ACROSS THE ST FROM THE PROP PLS LC GAS LINE FROM ST TO METER
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START DATE. . . . . .10/15/2010 START TIME. .07:00
CALLER. . . . . . . . . .BARNEY YOST
CALL BACK. . . . . . .8-5
PHONE #. . . . . . . . .860-871-0468
FAX #. . . . . . . . . . .
ALT. PHONE #. . . .
EMAIL ADDRESS. . .
CONTRACTOR. . . . . .S.T.I. ASSOCIATES
ADDRESS. . . . . . . . .P.O BOX 797
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