HomeMy WebLinkAboutDrain Layers Permits 50 Edgewood Drive • 1100018 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 06/08/11 = ,
GIS ID:29400050 =_ FEE: 60.00
MUNIS APPLICATION# 201100561 EXPIRATION DATE: 07/08/11
APPLICANT----
LOCATION
NAME: JDC ENTERPRISES INC ADDRESS: 50 EDGWOOD DRIVE
ADDRESS: 420 JOHN FITCH BLVD - " OWNER: BLOWERS WILLARD G&JANICE M
PO BOX 905 = 50..E I OOD DRIVE
SOUTH WINDSOR,C-T 05074 SOUTH V4�INDSOR,CT 06074
PHONE
WORK DESCRIPTION: NEW SEWER�ONNECTIOfi+3 ,
THE DRAIN LAYER ASSIGNED TO THIS PERMIT HAS A UAI ID LICENSE ISSUED BY-THE--STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FOR TH.IN THEATTACHI D`CONDITIONS .`ALL-WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHA REQUIREMENTS,AND THE ATTACHED CONDITIONS.
/09
ISSUED BY DATE INSPECTED INSPECTED BY
6/8/2011 9:09 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I I i 00 CONTRACTOR:
LOCATION:
TYPE OF WORK: V'AeLA) S2L-0 CD Y)Ptfc�f-I d Yl
DATE INSP NEEDED: DATE INSP:
a
INSPECTED BY:
WORK IN
PROGRESS: Ede•• -��o ,� ` ;�teol � �� (��Pt' s�2 3� j r -,
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES [ VO
AS-BUILT:
INPUT: DATE: 0 . i I
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:.50 �?J[-�c'�G�-cT� 2 Lot
Street No. Street Name
Premises owned by:6/2 4 4- �� 4Gy�
Name of Firm:�� C �� /LIS�3 "`J� Phone:�r
Address of Firm: goX 9,0 �
�S'92
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with �5�2 3 S
Existing Water Supply: Public Water Well
Proposed Start Date 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 holder of Drain
Layer's License No. 0A 08,3a3 P 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 Permi nd/or ConnDOT Permit No.
PLEASE NOTE:
CBYD No,-/O// IFA SANITARYSEWER LATERAL
IS WITHIN75 FEET OF WELL
IT MUST SEAIR TESTED
Signed: Print Name:
/Licensed Drain Lay
Date: & r ^/,/
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY ;- SEWER' LATERALTIELD . LOCATION
DATE OF CONSTRUCTION: r-��
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SUBDIVISION:
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TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
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