HomeMy WebLinkAbout761 Griffin Road 1200029 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 06/26/12 -= -
GIS ID: 39000761 - FEE: 60.00
MUNIS APPLICATION# 201200843 EXPIRATION DATE: 07/26/12
APPLICANT -- LOCATION
NAME: HINCKLEY CONSTRUCTION INC ADDRESS:. 761=GRIFFIN ROAD
ADDRESS: 178 HIGHLAND VIEW DRIVE OVER: GUARINO HOMES LLC
SOMERS, CT 06071 - 58 RYE ST
8ROAD BROOK, CT 06016
PHONE -
WORK DESCRIPTION: NEW SE*E ONN
_EC TIO T-
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 FORTE 11 THE ATTAd -- `CONIITIONS ,"ALL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,AL�OSHA REQUFREMENTS,AND-THE ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
6/26/2012 11:33 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: / oZQ� CONTRACTOR:
LOCATION: 7 � 0
TYPE OF WORK: Se Lam-- C o v-)Y,�c)
DATE INSP NEEDED: DATE INSP: 4 kzqL1-.2
INSPECTED BY: 46t)
WORK IN
PROGRESS,: /CeA-nc,,b✓ i�� [a`' pJC cba- 36: From S+wb
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: 0-
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLI TI CA ON FOR DRAIN LAZIER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVAN AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: Lot #
Street No. Street Name
Premises owned by: C,
Name of Firm:- Cgr4 c Phone:S-G o
Address of Firm:__1 -13 \-�,'-d► �
TYPE OF WORK:
Lay House Drainer Repair.House Drain
Lay Main : Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with Ce S O R 3�
Existing Water Supply: Public Water Well
Proposed Start Date C. Estimated time for completion A tnn e
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 VA ,N may Co`in ST the holder of Drain
Layer's License No. L m•oasts P'�.. 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 WITHIN75 FEE T OF WELL
IT M11ST BEAIR TESTED
Signed:_�� Print Name:
LicensM Drain Layer /
Date: LAO'!�- ad a
Standard Farms\Permits\APPLICATION FOR DRAIN LAYERS PERMTT.doc