HomeMy WebLinkAboutDrain Layers Permits 163 Frazer Fir Road 1200032 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 07/02/12
GIS ID: 34430163 FEE: 60.00
MUNIS APPLICATION# 201200858 EXPIRATION DATE: 08/01/12
LOCATION APPLICANT"
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NAME: EAGLE EARTHWORK SERV" ADDRESS- 163 FRAZER FIR ROAD
ADDRESS: 101 N MOUNTAIN ROAD- OWNER` N ANN) 0 BUILDERS LLC
CANTON,CT 06019 CHAPEL ROAD#3F
- S9 JTH WINDSOR,CT 06074
PHONE 860-693 2027;
WORK DESCRIPTION: NEW SEWEI�GONI�-ECTIOIxI
THE DRAIN LAYER ASSIGNED TO THIS PERMIT HAS A VALID LICENSE ISSUED_BY THE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH INTHE`ATTACHI I3`CONI3ITION,_,'ALL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS AI L OSHA REQUFREMENT ;AIaID THE ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
7/2/2012 9:56 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /,�660 3� CONTRACTOR: &c?l&7 7 h C.apY,l.
LOCATION: Ze'7 I- l
TYPE OF WORK:_ ��Go �laLtWe �, 642 0
DATE INSP NEEDED: DATE INSP: 71abg
INSPECTED BY: B1�_
WORK IN
PROGRESS: c1C1,n�-�c��- ,',� �'/�� � ( /°VLl Sb fa
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C DATE:
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
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: -x� Lot # 3
Street No. Street Name '
Premises owned by: /Itd9rr,We
Name of Firm: &—""ZA4. Phone: 64 7
Address of Firm: 0/ V--Qz]4 A4 L 45ki CX&AC761
TYPE OF WORK:
Lay House Drain_; Repair.House Drain
Lay Main • Lay Lateral for Commercial/Industrial
Buiidina of ages
Connection will be made with �e.� u PVC
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 �%,661yl( i the holder of Drain
Layer's License No. &n11,C 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 WITHIN75FEET OF WELL
IT MUST BEAIR TESTED
Signed: Fin Name: , 'i�; it)A�� r
1 License Drain Layer
Date:
standard Forms\Per nits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 7-16'- ki
BUILDING ADDRESS ;�3 "
t
STREET
SUBDIVISION:
NORTH ARROW
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CONT OR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
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S EET ADDRESS SI TURE
Z � �� 7 � ATE
TOWN STATE ZIP INSPECTED BY TOWN
M16 Q :a :j--o f DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER