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HomeMy WebLinkAboutDrain Layers Permits 71 Quarry Brook Dri 1200006 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 02/21/12 GIS ID: 74100071 = FEE: 60.00 MUNIS APPLICATION# 201200151 = EXPIRATION DATE: 03/22/12 JV APPLICANV Al - LOCATION NAME: JDC ENTERPRISES IIG ADDRESS. 71 QUAtRY BROOK DRIVE ADDRESS: 420 JOHN FITCH BLVI�� flNER. PLATTFS ALAN M&TERESA A PO BOX 905 = - 71 QUARRY BROOK DRI SOUTH WINDSOR,CJTad&074 - SOUTH WINDSOR, CT 06074 PHONE WORK DESCRIPTION: EMERGBNC AR'no ATER LREFAJR THE DRAIN LAYER ASSIGNED TO THIS 1?ERIW-HAS A UA,LIF}L1 ENg-E ISSUED=$Y-THE TATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FORTIS III I Ijt ATTA D -C M*ONS-k ALJ W{ RK SHALL BE IN ACCORDANCE WITH 1�SfAL�L THE TOWN OF SOUTH WINDSOR STANDA OSIJA REQUIREMENT--- AN3 THE ATTACHED CONDITIONS. lIL? I X/ - ISSUED BY DATE INS CTED INSPECTED BY 2/21/2012 10:38 AM ' - TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.:_ OONTRACTOR: a,� LOCATION: U L Q p I� 3 'TYPE OF WORK: -DATE INSP NEEDED: DATE INSP: T INSPECTED BY.- WORK IN PROGRESS: � ©% i�s �cCQI SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES [:] NO AS-BUILT: INPUT:_ DATE: 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: ZZ E LI XZCekLot # Street No. gireet Name Premises owned by: Name of Firm: 7—"b `-<phone:�� Address of Firm: ��• l7 �'D TYPE OF WORK: / Lay House Drain_; Repair.House Drain f/ : Lay Main ; Lay Lateral for Commercial/Industrial Building of aces Connection will be made with -S' 26 2. .3,15" Existing Water Supply: Public Water-�e� Well Proposed Start Date � 2 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 &"y the older of Drain Layer's License No. 0 3 3 Only holders of P-1, rr 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 N IFA SA NITA R Y SEWER LATERAL IS WI THIN75FEHlOFA WELL IT MUST BEAIR TESTED Signed: Print Name: 6y Licensed Drain Date: -1�— Standard Forms\Permits\APP1ICA170N hOR DRAIN LAYERS PERMrr.doc Molloy, Catherine From: CallCenter@CBYD.com Sent: Monday, February 20, 2012 11:51 AM To: CBYD Subject: Locate Request-20120800059 (CALL BEFORE YOU DIG - CT) 02/20/2012 11:51:20 -5G -C1 -GV -OT 2-SW SWINDS -T5 -W3 -------------------------------------------------------------------------- ***** EMERGENCY ***** TIME. .11:50 DATE. .02/20/2012 REQUEST NO. . .20120800059 LATITUDE. .41.8165476 LONGITUDE. .-72.5861792 TOWN. . . . . .SOUTH WINDSOR ADDRESS. . .71 STREET. . . .QUARRY BROOK DR NEAREST CROSS STREET. .SIMKA DR -------------------------------------------------------------------------- TYPE OF WORK. . . . .EMER SEWER PIPE REP AREA IS MARKED. . .YES REMARKS: LOC 6FT OFF CURB TO OTHER SIDE OF CITY SIDEWALK CREW EN ROUTE A24 JMM 022012 1150 -------------------------------------------------------------------------- START DATE. . . . . .02/20/2012 START TIME. .13:00 CALLER. . . . . . . . . .JD CAREY CALL BACK. . . . . . .ANYTIME PHONE #. . . . . . . . .860-250-5391 FAX #. . . . . . . . . . .860-667-4164 ALT. PHONE #. . . . EMAIL ADDRESS. . .JDCENTERPRISES@AOL.COM CONTRACTOR. . . . . .J D C ENTERPRISES ADDRESS. . . . . . . . .P. 0. BOX 905 CITY. . . . . . . . . . . .SOUTH WINDSOR STATE. . . . . . . . . . .CT ZIP. . . . . . . . . . . . .06074 -------------------------------------------------------------------------- EXCAVATOR DOING WORK. .SAME AS NOTIFIED ISSUED TO: DATE: TIME: BY: DATE/TIME ARRIVED: TIME LEFT: COMPLETED BY: CALL BACK: 1) DATE: TIME: BY: 2) DATE: TIME: BY: PERSON CONTACTED: PERSON CONTACTED: 1 TOWN OF SOUTH WINDSOR SANITARY SE WER LATERAL 'FIELD LOCATION DATE OF CONSTRUCTION: ���� ✓ �� BUILDING ADDRESS 21. d 62-e-70fC I STREET SUBDIVISION: NORTH ARROW - } . Tr --rl- E ` :t�( i g i € m >3 _ COW ICTOR (PRINT) NAME OF C UP SO (PRINT) � s STREET ADDRESS SIGNATURE .�d /fib J`v U�o d'f DATE T STATE ZIP INSPECTED BY TOWN az.) DATE TELEPHONE NUMBER WHITE - TOWN PINK CONTRACTOR YELLOW - CONSULTING .ENGINEER / DEVELOPER