HomeMy WebLinkAboutDrain Layers Permits 102 Frazer Fir Road 1200031 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 07/02/12 - -
GIS ID: 34430102 - FEE: 60.00
MUNIS APPLICATION# 201200856 = EXPIRATION DATE: 08/01/12
APPLICANT = =; 7p LOCATION
NAME: EAGLE EARTHWORK SERV ADDRESS; t02-=PRAZER FIR ROAD
ADDRESS: 101 N MOUNTAIN ROADDWIER: MANNARINO BUILDERS LLC
CANTON, CT 06019 4�0 CHAPEL ROAD#3F
SOJTH WINDSOR,CT 06074
PHONE 860-693 2027 -
WORK DESCRIPTION: NEW SERVER CONNP TI(1N ;
THE DRAIN LAYER ASSIGNED TO THIS PERMITHAS A VAL a_LlC-EN�E ISSUED BY-THE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTIS IA1 TH,E ATTACHED`CONDITIONS', ALL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHA RE UREMENTS,AI�I THE-`ATTACHED CONDITIONS.
_-, ,
ISSUED BY DATE INSPECTED INSPECTED BY
7/2/2012 9:52 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: hoo. CONTRACTOR: 1 �'��^ mod✓`
LOCATION:_ / Z)a F-ra 2-eir rl g
TYPE OF WORK:
DATE INSP NEEDED: DATE I'NSP: . Ozl
INSPECTED BY: 6 +�
WORK IN
PROGRESS: � ���d-��
S&V TO koL' c 4'cLs 'lk SIceye e'1 FOOT
Casry c ��4 4-0 4 '° S c 4 it o by lt,"+
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: d---
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, Cr
FEE $60.00
Location of proposed work: Ae�. Lot #—W—
Street No. Street Name
Premises owned
by: &6",Ie ��
Name of Firm: l hone: �&—'—ey B �
Address of Firm:
TYPE OF WORK:
Lay House Drain. / _; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with �2P bp
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 Al---Ae W"&( the holder of Drain
Layer's License No. _JERI& 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. _ I� -SCE . IFA SANITARYSEWER LATERAL
IS WITHIN 75 FEET OFA WELL
IT MUST BEAIR TESTED
Signed: W nt Name:
Licensed Drain Layer
Dater
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY - .SEWER LATERAL 'FIELD LOCATION
DATE OF CONSTRUCTION: ''- � �-
BUILDING ADDRESS .
STREET
SUBDIVISION:
NORTH ARROW
IT 7
Nam no-
17
CON OR (PRINT) NAME OF ONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS �r SIGNATURE
C '�, ��a Li �� �>2DATE
TOWN� STATE ZIP INSPECTED BY TOWN
��►t�-�" ��� �- E�..C��"� DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER