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HomeMy WebLinkAboutDrain Layers Permit 15 Balsam Fir Road (2) 1100030 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 08/12/11 GIS ID: 07150015 - - ;- FEE: 60.00 MUNIS APPLICATION# 201100901 - EXPIRATION DATE: 09/11/11 APPLICANT - - = LOCATION NAME: MANNARINO BUILDERS INC ADDRESS., 15 BALSAM FIR ROAD ADDRESS: 400 CHAPEL ROAD RS INC UNIT 3F 400 CHAPEL RD#3F SOUTH WINDSOR,CT 7-4 = SOUTH WINDSOR,CT 06074 PHONE 860-289- 05 75 WORK DESCRIPTION: NEW SEWER-CONKECTIC3N THE DRAIN LAYER ASSIGNED TO THIS kRMli HAS A-VAt11)LIGI NSI ISSUED'I3Y TIDE STATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FOR*IN IHE ATTAHD`GONDITIONS':-ALL WORK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDARDS;ALL OSHA REQUIREMENTS,AND THE ATTACHED CONDITIONS. 000 ISSUED BY DATE INSPECTED INSPECTED BY 8/12/2011 9:03 AM TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: 1( b6'3© CONTRACTOR: 014A VIOLf t DO LOCATION: 15 BA <o ova e 2 TYPE OF WORK: eLAD e Wec' V) l)eqc_'j�D 11 DATE INSP NEEDED: DATE INSP: /z // INSPECTED BY: Sb WORK IN PROGRESS: zAdW sb p LeA� , iv,,7` c,-P Ae:a jo,1,ro 'eandLA SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: C - DATE: W/2007 Town of South Windsor INPSEMON REPORT 07 APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR . 1540 SULLIVAN AVENUE PUBLIC WORKS DEPARTMENT TOWN HALL SOUTH WINDSOR, CT FEE $60.00 Location of proposed work: _I &&V�jj PY�'b of # Street No. Street Name Premises owned by: AA&'tn-zV ea,>� Name of Firm: 641—AC -Cf Phone: Address of Firm: /0 / - 1e TYPE OF WORK: Lay House Drain; Repair House Drain ; Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with Existing Water Supply: Public Water_ Well Proposed Start Date "/,L--/ 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 A i'o-44 e( 1v,)eez,-t the holder of Drain Layer's License No. ::Qf bl b,"* . 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 attached thereto. Applicant has received Town Street Excavation Permit No. and/or ConnDOT Permit No. PLEASE NOTE: CBYD No.9al 310 7 9 IFA SANITARYSEWER LATERAL IS WITHIN 75 FEET OFA WELL IT MUST BEAIR TESTED Signed: 4vIr ame: APB �df p 'D Licensed Drain Layer Date:�1� -I//I Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS STREET : �l � r2 7J SUBDIVISION: 0 4-ree_ Ei � - NORTH ARROW .._ DO t t g L CONTRACTO A (PRINT) n NAIE OF CONTRACTOWS SUPERVISOR (PRINT) . STREET ADDRESS sTGNATGRE / E_�J�"v� (�/I ��©�cI ��� �►-G� Zt//�./<� DATE TOWN STATE ZIP INSPECTED BY TOWN DATE TELEPHONE NUMBER rt WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING .ENGINEER / DEVELOPER