HomeMy WebLinkAboutDrain Layers Permits 223 Nutmeg Road 1200052 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 10/11/12
GIS ID: 65100223 FEE: 60.00
MUNIS APPLICATION# 201201345 EXPIRATION DATE
APPLICAN =s h LOCATION
NAME: BUSINESS OWNER s A RE lU MEG ROAD
ADDRESS: SOUTH WINDSOR, f7 tV Z ASSOCIATES LLC
- U IDE AVE
TFORD,CT 06108
PHONEikky =,
WORK DESCRIPTION: NEW SE I
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THE DRAIN LAYER ASSIGNED TO THIS T RAS A II SIT. STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORT T E A I ¢ RK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STAND AQII QT ATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED BY
10/11/2012 3:56 PM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: D 104yc_�' CONTRACTOR: �4
LOCATION:_ U
TYPE OF WORK: a) Sa( 1, yl cl
DATE INSP NEEDED: DATE INSP: f r IiG lz
INSPECTED BY: BD
WORK IN
PROGRESS: i-ac�o,� �iv � .��cclC �arlly Coo Core- gx`s�✓y►9 sMH
7'�� l7ova rev.n "rF a cow fed °! ' o� G sD9 35-
aid �.7,r� T�4i°�' ;�:-�v�rc-� � k,��d �.�d r'�►5.1,0 ��®p
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: Co-- DATE:
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVAN AVENUE
1 ne SS
TOWN HALL
SOUTH WINDSOR,CT
FEE$60.00
_Location of proposed work: 2 Z.3 kain:�ffir-, Lot # 2 z..
Street No. treat Name
Premises owned by: !�wo re-Z AsSosrcJe_T
Name of Firm: A Phone: F60 ZUgo y&y
Address of Firm:- s'd.P
TYPE OF WORK:
Lay House Drain : Repair.House Drain :
Lay Main Nx" Lay Lateral for Commercial/Industrial
Building i of I•Y7 acres
Connection will be made with
Existing Water Supply: Public Water Well
Proposed Start Date 2 ,2�� Estimated time for completion k)oy t S Z.
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-A A J nLe �,r,,e�_). LC c the holder of Dram
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.
PLEASE NOTE:
CBYD No.�201 Zq/O 28 IFA SANITARYSEWER LATERAL
IS WITHINi'75 FEE T OF WELL
IT MUST BEAIR TESTED
Signed: Print Name: A7eLtke AWC-i Z
License Drain Layer
Date:_ /G --«-Zo 12
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET fzJ So ttA
SUBDIVISION:
NORTH ARROW pvc S DR 3,S
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CONTRACTOR (PRINT) NAME F CO TRACTORS SUPE VISOR (PRINT)
STREET ADDRESS SKOATURE
RtiC,\,(,� _d /.SATE
TOWN STATE ZIP INSPECTED BY TOWN
13&0- f);2/- 0 ) y�? DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER