HomeMy WebLinkAboutDrain Layers Permits 182 Smith Street (2) 1100027 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 07/25/11 ==
GIS ID: 83700182 - FEE: 60.00
MUNIS APPLICATION# 201100786 EXPIRATION DATE: 08/24/11
APPLICANT LOCATION
NAME: KF REALTY LLC ADDRESS: 182-9MIT11 STREET
ADDRESS: 972 PLEASANT VALLEROAD = OWIET: K PDERTIES LLC
SOUTH WINDSOR,GT-0607-4 17 WHEELER RD
OU PHONE �:
TI WINDSOR,CT 06074
WORK DESCRIPTION: NEW SEV�E-CONNECTIdfi1
THE DRAIN LAYER ASSIGNED TO THIS PERMIT HAS A VALID LICENSE ISSUED BY III$STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORThi TEE A -TAt!i4 `CONDITIONS`ALL W RK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDA16 ALi OSHA REQUIREMENTS -ANi3 THE ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
7/25/2011 10:57 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: Z CONTRACTOR: gro Aycy S_
LOCATION: T"l�
TYPE OF WORK:_ ( Lt7 SeC, )t Keg r)
DATE INSP NEEDED: DATE INSP: ? _
INSPECTED BY: �
WORK IN r
PROGRESS: (� �s '' ,�'UL j51� /3s^ �� IGiy1 cS•�.`c?a
�yl Sw'i " 4 "_Sc l 7® -%, yq
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES [] NO
AS-BUILT: I
INPUT: Ci N� DATE:
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W12007 Town of South Windsor INPSECTION REPORT 07
/lDooa �
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVAN AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL
SOUTH WINDSOR, CT
FEE $60.00
l
Location of proposed work.. ez I A Lot #
Street No. Street Name
/ 1t
Premises owned by: ` �'' `r`'T el-6 C
Name of Firm:_ ALr � Phone: G
Address of Firm: 1 �1
TYPE OF WORK:
Lay House Drain_; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of - acres
Connection will be made with �— e ycJ e-4 ci u PV C
- Existing Water Supply: Public Water Well
Proposed Start Date � Estimated time for completion 7—
el
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 issue� o �� 1K,L L the holder of Drain
Layer's License No. l" 1'1 D 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 att c red thereto. Applicant has received
Town StrAelt xcavation Permit No. and/or ConnDOT Permit No.
�V
PLEASE NOTE:
CBYD No. f U/d, IFA SANITARYSEWER LATERAL
IS WITHIN 75 FEET OFA WELL
IT MUST BEAIR TESTED
Signed: Print Name:
9 —
Licensed Drain Layer
Date: /=/Z
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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