HomeMy WebLinkAboutDrain Layers Permits 80 Greenwood Drive 1100046 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 12/02/11 "
GIS ID: 38700080 "- = "" FEE: 60.00
MUNIS APPLICATION# 201101444 EXPIRATION DATE: 01/01/12
APPLICA T-f TJLOCATION
NAME: EAGLE EARTHWORK SERV `ADDRESr:. 8�GREENWOOD DRIVE
ADDRESS: 101 N MOUNTAIN RQAD_ = pER: AYOUB PASHA A
CANTON,CT 06019 6$9 DMNG ST
PHONE SOUI WINDSOR,CT 06074
860-693 2027-
WORK DESCRIPTION: NEW SE*ER,CONN GTIO
THE DRAIN LAYER ASSIGNED TO THIS 1R1YlIT HAS A VAI ID LIGEN$ ISSUED 13Y TIEsTATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTkf I HE ATTACI4ED`CONDITIONS: ALL W(pRK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARl!3S ALL OSHA REQUIREMENTS AND THE"ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
12/2/2011 8:04 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 60 CONTRACTOR:
LOCA77ON:
_TYPE OF WORK: - 2,c,c} ���'1 n -►.�y�
DATE INSP NEEDED: DATE INSP: 12 49li
INSPECTED BY: 0
WORK IN ii rrcc ``
PROGRESS:4ta
_ G n :rn r�r,r ✓i S7'a N�,�l rr P V�,
3
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
'AS-BUILT.-
INPUT. DATE:
W12007 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:a (�-1- (�p� b hi Lot #
Street No. Street Name
Premises owned by: 94YAqdl
Name of Firm: t.: 4 Q/e �40'4 &,M 4 Phone: 40-403-X91-7
Address of Firm: MWA eA,
TYPE OF WORK:
Lay House Drain; Repair House Drain ;
Lay Main , Lay Lateral for Commercial/Industrial k<
Building of acres
Connection will be made with t IPVC
Existing Water Supply: Public Water. Well
Proposed Start Date �a ' Estimated time for completion —6-=/4
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 �G �it7 the holder of Drain
Layer's License No. . 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. IFA SANITARYSEWER LATERAL
IS WITHIN 7S FEET OFA WELL
IT MUST BEAIR TESTED
Signed: int 11ame:
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
i
TOWN OF SOUTH NINDSOR
SANITARY - SEWER LATERAL 'FIE LD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS .
I�GW0104 Q 7
STREET �9 !?4 uJan b. ,,P
SUBDIVISION: hOViAl(A Elf jrr<
NORTH ARROW
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— `�
COO TOR (PRINT) NAME F CONTRACTOR'S SUPERVISOR (PRINT)
STREET'A DRESS �-z--- SIG RE
4 � �, ���� 12101
DATE
TOWN STATE ZIP INSPECTED BY TOWN
ffo,au-2o2 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER