HomeMy WebLinkAboutDrain Layers Permits 142 Frazer Fir Road 1200030 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 07/02/12
GIS ID: 34430142 FEE: 60.00
MUNIS APPLICATION# 201200855 EXPIRATION DATE: 08/01/12
APPLICANT LOCATION
NAME: EAGLE EARTHWORK SERV ADDRESS: 142 FRAZER FIR ROAD
ADDRESS: 101 N MOUNTAIN ROAD OWNER: MANNARINO BUILDERS LLC
CANTON, CT 06019 400 CHAPEL ROAD#3F
SOUTH WINDSOR,CT 06074
PHONE 860-693-2027
WORK DESCRIPTION: NEW SEWER CONNECTION
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 IN THE ATTACHED`CONDITIONS'. ALL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHA REQUIREMENTS,AND THE ATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED BY
7/2/2012 8:29 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: Id e)06 o CONTRACTOR: (fo
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LOCATION: 17 a r(4 2e(- �'I
TYPE OF WORK: oe vo seuje c ► ec41 o n
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: too
WORK IN
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SEPTIC TANK PUMPED', SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT: L/
INPUT: C DATE:
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: / / Lot #
Street No. Street Name
Premises owned by: P?L6 J9&I jel
Name of Firm:J Phone: -50
Address of Firm: � ZVO
TYPE OF WORK:
Lay House Drain- Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with ��-
Existing Water Supply: Public Water, Well
Proposed Start Date VWfr-Estimated time for completion — P
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 the holder of Drain
Layer's License No. 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.
CBYD No. S�! a�r// ,6.
Signed: qz0& - .Print Name: // ///iC(Q�(
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Licensed Drain Layer
Dater
Standard Forms\Permits\APPLIGATION FOR DRAIN LAYERS PERMrr.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: L-'�-` U
BUILDING ADDRESS LO-" L4II J� 1
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STREET
SUBDIVISION: r
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CONTRA R (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
lot "rA M 9mb —&J", IV
STREET ADDRESS SIGNATURE
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TO STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER