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HomeMy WebLinkAboutDrain Layers Permits 3 Oakwood Drive (2) 1100034 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 09/13/11 GIS ID: 66000003 - FEE: 60.00 MUNIS APPLICATION# 201101027 EXPIRATION DATE: 10/13/11 APPLICANT = , " . LOCATION NAME: AJ&J EXCAVATION lg`k ADDRESS>- 5 OAK OOD DRIVE ADDRESS: 21 CLINT ELDREDGE ROADER: OONNR JOHN A&SHERYL M WILLINGTON,CT 062791702 = OKWOD DRIVE ; OIJTH V4�INDSOR,CT 06074 PHONE WORK DESCRIPTION: NEW SEWER S©NIIViCTIO I THE DRAIN LAYER ASSIGNED TO THIS PERMTI AS A VALID LTGFII ISSUEL2-$Y THE, TATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FORTH W TIH-E ATTACft -O�TDITI0NS'. Al I W(5RK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDARI2Sr AT L OSHA RhQI-J&It MQENTS,AN&11W ATTACHED CONDITIONS. ISSUED BY DATE INSPECTED INSPECTED BY 9/13/2011 11:28 AM TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: CONTRACTOR: �kCa LOCATION: 3 c,k UJ 0 o4 .TYPE OF WORK:_ f U3 S DATE INSP NEEDED: DATE INSP: 9/Z///l INSPECTED BY:_,L WORK IN PROGRESS t I :���.c.cto� Z-•nS�ciL�Q� Lo.e P✓C 5'�lr 3� ro w S cf © a SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: W12007 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: ©tom uco0 .ne- Lot # Street No. Street Name i Premises owned by: Name of Firm: Aa4- T Phone:�0 Address of Firm: 21 r l;Af E(AC&4 r <d- Lu i 11Ih�,quyv- C 106.9_7c TYPE OF WORK: Lay House Drain k"' ; Repair House Drain ; Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with 12- SS Existing Water Supply: Public Water Well Proposed Start Date -13- 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 SEs b4doi56ETr the holder of Drain Layer's License No. Parr► 029yR.T8 -p? 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. 0(011 -- 31900 9 rFA SANITARYSEWER LATERAL IS WITHIN75 FEET OF WELL IT MUST SEAlR TESTED Signed: Print Name: Lice rain Layer Date: Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL 'FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS : 3 C)Ak (k)oab rive STREET SUBDIVISION: NO ARROW b R 36' _ O Ant ZY a CONTRACTOR (PRINT) NAME OF CONTRACTOR'S RVISOR (PRINT) STREET ADDRESS SI RE Awry lA//d&Z cr TOWN �► STATE ZIP INSPECTED BY TOWN DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING .ENGINEER / DEVELOPER