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HomeMy WebLinkAboutDrain Layers Permits 230 Brook Street 1200035 TOWN OF SOUTH WINDSOR, CT PENT NUMBER DRAIN LAYER PERMIT DATE: 07/23/12 % GIS ID: 14400230 FEE: 60.00 MUNIS APPLICATION# 201200925 y_ EXPIRATION DATE: 08/22/12 APPLICANTLOCATION NAME: SKIPS SEPTIC ADDRES` "ROOK STREET ADDRESS: 6 NUTMEG DRIVE % ENS MCHAEL E&WINDY A P O BOX 29 � 0K STREET ELLINGTON,CT 0602�; �£IJTi WINDSOR,CT 06074 PHONE 860-875-t3-32mig � WORK DESCRIPTION: NEW SEWF CONWT , 0 y THE DRAIN LAYER ASSIGNED TO THIS VIE T%ti- A IS IJI3 Y �IIE TATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FORTI�H1 = I IbN$ AIS2K SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDAAQ& O IA Et al T ATTACHED CONDITIONS. ISSUED BY DA E IN PECTED SPECTED BY 7/23/2012 8:42 AM i i i i y 0 q'y. JA y �j 'r iv i gj APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR PUB1 C WORKS DEPARTMENT TOWN HALL 154#0 SULLIVAN AVENUE SOUTH WINDSOR, CT f O-oO FEE �P Location of proposed work: 230 9;Z0dk- 3T Lot # Street No. Street Name Premises owned by: /31<C L 6-0 I\j S Name of Firm: S,PT7c— Phone: %J $1 r 23 3 q_ Address of Firm: N(frrn £G 3)1Z — (D 0. t3ex Z C e-AJ nl TYPE OF WORK: Lay House Drain V— ; Repair House Drain ; Loy Main ; t-ay Lateral for Commercial/Industrial Building of acres Connection will be made with t f V L &l /?_ 3 1— Existing Water Supply: Public Water Well -/— Proposed Start Date wA of 17 Z 3 3 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 -r-&k AJe)-K£ iZ the holder of Drain Layer's License No. o a,),7?z J Only holders of P1 o P7 Icenses 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. CBYD No. 0 1 O C Z 8 g - - Signed:4- - - Print Name: Li nsed Drain Layer Date: 7l7 112— Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.:_/ ©C)03S CONTRACTOR: LOCATION: �,�l� �L�7��L S�'• TYPE OF WORK: 6b pi ne f17)J!:� DATE INSP NEEDED: DATE INSP: 1/4 Y/IL INSPECTED BY: WORK IN PROGRESS: ad Lod ed l It .Lk, yb,;# ti bl uk A.P.S p16.�& C le rn oil ail b i,-n c or h lr Co"Ke49111„ ad Lx�S lr�,� hadd►g► saucer In LtI7 a'( 46'il--. -cp ti shied 44 rAll�WIoa d� . A Ir J/5l le 3, � ns,' �'<✓ 0 Ayen P/ SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES I(NO AS-BUILT: INPUT: DATE: S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION 07/27/2012 08:29 8608750428 SKIPS PAGE 01/01 TOWN OF` :S"OUTH VINDSOR SANITARY- SEWER - LATERAL FIELD LOCATION ` DATE OF CONSTRUCTION: '7Z � B.UILDING' ADDRESS , + SUBDIVISION: - NORTH ARROW Ilk > fjAt- K72- _ I I' CONTRACTOR (PRINT): NAME OF CONTRACTOR'S SUPERVISOR A, ., , -STREET ADDRESS -_ SIG TURF DATE TOWN STATE ZIP INSPECTED BY TOWN DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER