HomeMy WebLinkAboutDrain Layers Permits 3 Oakwood Drive 1100021 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 07/15/11 - =
GIS ID: 66000003 = FEE: 60.00
MUNIS APPLICATION# 201100764 fgz7 EXPIRATION DATE: 08/14/11
APPLICANT ` - LOCATION
NAME: AJ&J EXCAVATION L; C ADDRESS 3 OAKWQOD DRIVE
ADDRESS: 21 CLINT ELDREDGE ffRD 9W ER QGONNOR JOHN A&SHERYL M
WILLINGTON,CT 06279-J70 3 QAKW6OD DRIVE
2 A, ; UJTH VINDSOR,CT 06074
PHONE
WORK DESCRIPTION: NEW SEWRICQNECTION ` =
THE DRAIN LAYER ASSIGNED TO THIS PERI�TT -AS AV-AtJD LIB EMgE ISSUER$Y TFfE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTIS IN T IE ATTACHED`CQNIaIT1QNS1 ALL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,AID,OSHA.REQUIREMENTS,'AID THE-ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
7/15/2011 12:03 PM
4
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 000,Q CONTRACTOR: 14S4-,T (`Xccx\)g.i)
LOCATION: ;3 QG )(_W 6 of
TYPE OF WORK: /j e t-i o vn v;t-c:6 o y1
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
W/2007 Town of South Windsor INPSECTION 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: 06 K Mob .hP_ Lot #
Street No. Street Name
Premises owned by:
Name of Firm:s" -S F_X C"A--T) o0) Phone: HbO 1190 409
Address of Firm: A I C 1 ce!b f Ed GV i 11;rnd2Lk= (`r C6.9-W
TYPE OF WORK:
Lay House Drain sewer' ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with w << 5 b?_3S
Existing Water Supply: Public Water Well
Proposed Start Date___RUL`� I SEstimated time for completion VL
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 SEFI= b A66 Of the holder of Drain
Layer's License No. 'PL M ba By aS-PP'7. 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. ;20) 1 a SO a-7 6 8 IFA SANITARYSEWER LATERAL
IS WITHIN 75 FEET OF WELL
IT MUST SEAIR TESTED
Signed: _. Print Name: S A66F_11 -
License in Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc