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Home My WebLink Aboutdrain layer permit 34 Norton Lane 1000055 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 10/26/10 s ' GIS ID: 64800034 �3 MUNIS APPLICATION# 201001450 FEE: 60.00 IRATION DATE: 11/25/10 APPLICAN OQ` DOCALOCATION NAME: WASTEWATER SER ADDRESS: 100 B WINDERME 3 NOR ON LANE ELLINGTON,CT 06 ' UGH DANIEL G - N LANE PHONE 4 = may? SOR CT 06074 -' ` Ji - WORK DESCRIPTION: NE E 1 APPLICANT AGREES TO FURNISH THE THE TOWN OF SOUTH WINDSOR FOR A T_ ND REQUIRED AND TO REIMBURSE CONNECTION WITH THIS PERMIT AND TH T AINTENANCE OR REPAIR WORK IN FOR PERMITS AS OUTLINED IN THE TOWN OF I A` - L ABIDE BY THE RULES AND REGULATIONS fiP IT MANUAL. - - ; ISSUED BY DATE lIVSPECTED INSPECTED BY 10/26/201011:17AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** -- -... ....--------------- fg � g 3 y ZW - z - " fra � TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: " .� .�5 CONTRACTOR: W 4S U� LOCATION-3 /W e_-J)n ta Ne TYPE OF WORK: Wes. cc Y1 "C�j0 y1, DATE INSP NEEDED: DATE INSP: INSPECTED BY: 6 D WORK IN PROGRESS: �n � zw `e� (� PVC SbM3 e,,&J.C.W SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED YES ❑ NO AS-BUILT: !/ INPUT: 12*' DATE: IDIA10 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: �y 1 �a� � Lot # Street No.► Street Name Premises owned by: Pa (�✓�✓� k Name of Firm: G✓4s le.w.X, , ,e e s Lr- Phone: Address of Firm: M9 �11�vleltlelc Avc- TYPE OF WORK: Lay House Drain Repair House Drain Lay Main_ : Lay Lateral for Commerdai/Industrial Building of acres Connection will be made with SOR 75- 0. C/ Existing Water Supply: Public Water 1C Well Proposed Start Date 1v 2 Estimated time for completion I D� 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 os TI I.� /'Yl�e Ll. the holder of Drain Layer's License No.C� 2 77(SV A Y . Only holders of P-1, P-7 or W-9 licenses will be issued a permit. PERMIT WILL EKPIRE 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. Z ofo '136 3 3Z q Signed: Print Name: Licensed Drain Layer yY1lq c �►ris lO �mb�� S-�s v,c�5 L.L C , Date: G Standard FXM\PM t WPLICA-R0N FOR DRAIN LAYERS PERMIT.doc Sewer line installation for: Dan Cavanaugh 34 Norton Ln South Windsor,CT eA F� GIo 5««.%eJs, (OrV ZZv ti O � q ol'Cave/ C.J�- Ln 77 x Designed By: Wastewater Services Inc. 10/21/10 V -A 9aZ9- TOWN OF SOUTH WINDSOR SANITARY - SEWER LATERAL FIELD LOCATION DATE. OF CONSTRUCTION: I ° z7ho BUILDING ADDRESS -STREET Na laN L M SUBDIVISION: NORTH ARROW 4 �o iew A/ ti ►1 O � CONTRACTOR (PRINT) NAME OF CO OR'S P RVISOR (PRINT) f c)a13 �no1e1Ae/,rAr STREET ADDRESS SIGNATURE -F!1%n I k 07 06O z q TOWN STATE ZIP INSPECIED BY TOWN Q 0(-0 I—26 1,6 DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING .ENGINEER / DEVELOPER Form W-4. (2010) Complete all worksheets that apply.However,you payments using Form 1040-ES,Estimated Tax may claim fewer(or zero)allowances.For regular for Individuals.Otherwise,you may owe wages,withholding must be based on allowances additional tax.If you have pension or annuity Purpose.Complete Form W-4 so that your you claimed and may not be a flat amount or income,see Pub.919 to find out if you should employer can withhold the correct federal income percentage of wages. adjust your withholding on Form W-4 or W-4P. tax from your pay.Consider completing a new Head of household.Generally,you may claim Two earners or multiple jobs.If you have a Form W-4 each al situat on ear chap and when your personal or head of household filing status on your tax working spouse or more than one job,figure g return only if you are unmarried and pay more the total number of allowances you are entitled Exemption from withholding.If you are than 50%of the costs of keeping up a home to claim on all jobs using worksheets from only exempt,complete only lines 1,2,3,4,and 7 for yourself and your dependent(s)or other one Form W-4.Your withholding usually will and sign the form to validate it.Your exemption qualifying individuals.See Pub.501, be most accurate when all allowances are for 2010 expires February 16,2011.See Exemptions,Standard Deduction,and Filing claimed on the Form W-4 for the highest Pub.505,Tax Withholding Wd Estimated Tax. Information,for information. paying job and zero allowances are claimed on Note.You cannot claim exemption from Tax credits.You can take projected tax the others.See Pub.919 for details. withholding if(a)your income exceeds$950 credits into account in figuring your allowable Nonresident alien.If you are a nonresident and includes more than$300 of unearned number of withholding allowances.Credits for alien,see Notice 1392,Supplemental Form income(for example,interest and dividends) child or dependent care expenses and the W-4 Instructions for Nonresident Aliens,before and(b)another person can claim you as a child tax credit may be claimed using the completing this form. dependent on his or her tax return. Personal Allowances Worksheet below.See Basic instructions.If you are not exempt, Pub.919,How Do 1 Adjust My Tax Check your withholding.After your Form W-4 complete the Personal Allowances Worksheet Withholding,for information on converting takes effect,use Pub.919 to see how the below.The worksheets on page 2 further adjust your other credits into withholding allowances. amount you are having withheld compares to your withholding allowances based on itemized _ Nonwage income.If you have a lar a amount your projected total tax for 2010.See Pub. deductions,certain credits,adjustments to of nonwage income,such as interest e 919,especially if your earnings exceed $t30,000(Single)or$i80,000(Married}. income,or two-eamers/multiple jobs situations. dividends,consider making estimated tax Personal Allowances Worksheet(Keep for your records.) A Enter"1"for yourseff if no one else can claim you as a dependent. . . . . . . . . A •You are single and have only one job;or B Enter"1" if: ♦ You are married,have only one job,and your spouse does not work;or B •Your wages from a second job or your spouse's wages(or the total of both)are$1,500 or less. C Enter"1"for your spouse. But,you may choose to enter "-0-"if you are married and have either a working spouse or more than one job. (Entering "-0-"may help you avoid having too little tax withheld.) . . . . . . . . . C D Enter number of dependents(other than your spouse or yourself)you will claim on your tax return D E Enter"1"if you will file as head of household on your tax return(see conditions under Head of household above) E F Enter"1"if you have at least$1,800 of child or dependent care expenses for which you plan to claim a credit F (Note.Do not include child support payments.See Pub.503,Child and Dependent Care Expenses,for details.) G Child Tax Credit(including additional child tax credit).See Pub.972,Child Tax Credit,for more information. •If your total income will be less than$61,000($90,000 if married),enter"2"for each eligible child;then less"1"if you have three or more eligible children. • If your total income will be between$61,000 and$84,000($90,000 and$119,000 if married),enter"1"for each eligible child plus"1"additional if you have six or more eligible children. G H Add lines A through G and enter total here.(Note.This may be different from the number of exemptions you claim on your tax return.)► H For accuracy, •If you plan to itemize or claim adjustments to income and want to reduce your withholding,see the Deductions complete all and Adjustments Worksheet on page 2. worksheets •If you have more than one job orare married and you and your spouse both work and the combined earnings from all jobs exceed that apply. $18,000($32,000 if married),see the Two-flamers/Multiple Jobs Worksheet on page 2 to avoid having too little tax withheld. • If neither of the above situations applies,stop here and enter the number from line H on line 5 of Form W-4 below. ------------------------- Out here and give Form W-4 to your employer.Keep the top part for your records. --------------------------- Form .A, Employee's Withholding Allowance Certificate OMB No.1545-0074 Department of the Treasury ► Whether you are entitled to claim a certain number of allowances or exemption from withholding is 2010 Internal Revenue Service subject to review by the IRS.Your employer may be required to send a copy of this form to the IRS. 1 Type or print your first name and middle initial. Last name r 2 Your social security number fA i 5 Cat) 1 LI t 11. Home addre s(number and street or ral route) 3 / - Single ❑ Married ❑ Married,but withhold at higher Single rate. IL �- Note. married,ixrt legally separated,or spouse is a nonresident alien,check the`Singh"box. Cityor town,st to and ZIP code 4 if your last name differs from that shown on your social security card, r W check here.You must call 1-800-772-1213 for a replacement card. ► [l 5 Total rum er of allowances you are claiming(from line H above or from the applicable worksheet on page 2) 5 6 Additional amount,if any,you want withheld from each paycheck . . _ . . . . , . 6 7 1 claim exemption from withholding for 2010,and I certify that I meet both of the following conditions for exemption. • Last year I had aright to a refund of all federal income tax withheld because I had no tax liability and •This year I expect a refund of all federal income tax withheld because I expect to have no tax liability. If you meet both conditions,write"Exempt"here . . 7 Under penalties of perjury,1 declare that I ha;exaed t certificate and to the best of my knowledge and belief,it is true,correct,and complete. Employee's signature (Form is not valid unless you sign it.) ► Date ► to (f18 Employer s name and address(Emplolete lines 8 and 10 only if sending to the IRS.) 9 Office code(optional) 10 Employer identification number(EIN) For Privacy Act and Paperwork Reduc' n Act Notice,see page 2- Cat No.10220Q Form W-4 (2olo) STATE OF C ONNECTIOUT PLUMBING&PIPIi,(G I p CONTRACTOR JOSEPH 'MACVA,'.,ISH 264 GRyS�.AL LSD ELLY G--TobT--C'-`=06Q29 i LIC./REG NQ �EFECTNE EXPIRES PLM.02776 P «J<11/OI/20Q `E -10/31/2010 - SIGNED ;