HomeMy WebLinkAboutDrain Layers Permits 763 Griffin Road 1100022 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 07/15/11
GIS ID: 39000763 - ;_ FEE: 60.00
MUNIS APPLICATION# 201100766 = - EXPIRATION DATE: 08/14/11
APPLICAN = = - ;- LOCATION
'
NAME: AJ&J EXCAVATION VLC - ADDRESS: 763 GRIFFIN ROAD
ADDRESS: 21 CLINT ELDREDGE AEA = OEI GUAINQ HOMES LLC
WILLINGTON,CT 06:27�1'T1)2 258 RYE�T
BROOK, CT 06016
PHONE
WORK DESCRIPTION: NEW SERRONICTIC7IT = =
THE DRAIN LAYER ASSIGNED TO THIS I ERM' HAS A VALIDI ICENSE ISSUED BY THI--kATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORT N THE ATTA HEU -c-6 ITIONS .`ALL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS AEI,OSHA;REQUlEME�ITS,AND TIlE ATTACHED CONDITIONS.
ISSUED BY DATE INSPE TED INSPECTED BY
7/15/2011 4:13 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: ��/ 0009 1-)- CONTRACTOR: U
LOCATION: -7 �r r )-��1 ►� f'C d�
TYPE OF WORK: S evyey-
DATE INSP NEEDED: DATE INSP: Igi /I
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INSPECTED BY: f I G
WORK IN
PROGRESS: 'w �s G�' 6 b 'eyc- W'-f
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: VV\- DATE: x2_ 17 -1
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: 7 G 3 (f-l' fZ1f:4::'1 N R 0 Lot #
Street No. Street Name
Premises owned by:
Name of Firm: A- -rS E5 C6-yR---T#A1 _/lC Phone:-6o 5'Qo a6y6
Address of Firm: 6,1 C)in't e7 Ad W J ) I c'�`��^ <,T06a-7q
TYPE OF WORK:
Lay House Drain 59t ; Repair House Drain ;
Lay Main5ew_ 0r; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with � To b"S
Existing Water Supply: Public Water Well
Proposed Start Date �U Z-y 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 the holder of Drain
Layer's License No. A-M !SAS q;6F P7 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. S q 5 IFA SANITARYSEWER LATERAL
IS WITHIN 75 FEET OFA WELL
IT MUST SEAIR TESTED
Signed. Print Name: 7EFf--
Linens rain Layer
1-10
Date: 7-- kD-- 11
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS SIGNATtIPE
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TOWN ✓ / STATE P INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW CONSULTING .ENGINEER / DEVELOPER
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