HomeMy WebLinkAboutDrain Layers Permit 497 Abbe Road 1100043 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
DRAIN LAYER PERMIT
DATE: 11/09/11
GIS ID: 00600497 FEE: 60.00
MUNIS APPLICATION# 201101328 ' EXPIRATION DATE: 12/09/11
APPLICANT' LOCATION
NAME: AJ&J EXCAVATION LLC ADDRESS: 497 ABBE ROAD
ADDRESS: 21 CLINT ELDREDGE ROAD OWNER GUARINO HOMES LLC.
WILLiNGTON,CT 06279-�702 25$RYE vT
BROAD BROOK,CT 06016
PHONE
WORK DESCRIPTION: NEW SEWHIZ CONNECTION
THE DRAIN LAYER ASSIGNED TO THIS PERMIT HAS A VALID LICENSE ISSUEff., THE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH IN THE ATTACHED`CONDITIONS'., ALL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,AIL OSHA REQUIREMENTS,AND,THE'ATTACHED CONDITIONS.
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ISSUED BY AT SPECTED INSPECTED BY
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:� ,3 CONTRACTOR: .J CT
LOCATION:_ q 7
TYPE OF WORK__ / e
DATE INSP NEEDED: DATE INSP: l
INSPECTED BY: r►' �
WORK IN
PROGRESS:� VG 4 s 9
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SEPTIC TANK PUMPED, SMASHED, FILLED /1 WITNESSED El YES ❑ NO
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INPUT: DATE: 1 /
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W12007 Town of South Windsor INPSEc noN 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: 4F/-7 1516g�E Ats Lot #
Street No. Street Name
Premises owned by: &—"(1A`RiN0 if 6 t
Name of Firm:__ ExC4\14-Tro Phone: 'FGd -091-/;6
Address of Firm: 1 C f n ���Pd� f ( �
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with r� :s-oi.r 0
Existing Water Supply: Public Water_ Well
Proposed Start Date IVOU !— Estimated time for completion X10V
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 _ - /i the holder of Drain
Layer`s License No. Ptm O-Q18 qQT?-P,7Only 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. OtO 11 cI60 I a IFA SANITARYSEWER LATERAL
IS WITHIN 75 FEET OFA WELL
IT MUST SEAIR TESTED
Signe Print Name: -I�NA
icens rain Layer
Date: /l MI
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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