HomeMy WebLinkAboutDrain Layers Permits 172 Frazer Fir Road (2) 1300016 TOWN OF SOUTH WINDSO
PERMIT NUMBER R, C T
DRAIN LAYER PERMIT
DATE: 06/27/2013 = =-
GIS ID: 34430172
MUNIS APPLICATION# 201300892 FEE: 60.00
_All EXPIRATION DATE: 07/27/2013
APPLICAN � LOCATION
NAME: EAGLE EARTHWO ���
OF w -� DRE 172 R ER FIR ROAD
ADDRESS: 101 N MOUNTAIN ROO`
CANTON,CT 06019 EI A1N�TA�ZIN0 BUILDERS INC
= 490 CHAPEL ROAD
PHONE " i I
860-693 027
WORK DESCRIPTION: NEW SEA /Mk
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THE DRAIN LAYER ASSIGNED TO THIS PI RIT I4AS A�'
THE TERMS AND CONDITIONS SET FORTE BE"A� ��IQ TATE AND SHALL BE HEIN REBY
AGREES TO WITH
THE TOWN OF SOUTH WINDSOR STANDAA� Aa OS1`I�� j T ANH TIDE ATTACHED CONDITIONS.
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ISSUED BY / � �
DATE INSPECTED INSPECTED BY
6/27/2013 10:39 AM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO._ 1 CRACTOR: a :cccc .
LOCATION:
TYPE OF WORK:_
DATE INSP NEEDED.
DATE INSP: 711 /
INSPECTED BY:
WORK IN
PROGRESS;, +,
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C. DATE: 7Lb-
S/FORMSITOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR DRAIN LAYER PERMTf
TOWN OF SOUTH WINDSOR
1540 SULLIVAN-AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL
SOUTH WINDSOR,CT
FEE$60.00
4=tjon of ro 7
P . Posed work:_ -1 � ���- � trot#
Street No. Stet Name
Premises owned byL .A01.,
Name of Frm: �� '4�ar�,N i Phone: -POZ7
Address of firm: i0/ XJ®�?2-A� RA
TYPE OF WORK:
Lay House Drain._ � Repair_House Drain
Lay Main Lay Lateral for Commercial/Industrial
Building of acres.
Connection will be made with ' 4 /�
Existing Water Supply: Public Water_ Weii
Proposed Start Date Estimated time for completion
ALL WORK TO BE IN ACOORDANCE WITH 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. • ->A 1/�_. Only hotd� f P-1, P-7 or W9 licenses
will be issues p permit. PERMrr WILL EXPIRE'i iftkIY(30) DAYS AF1rER
DATE OF ISSUANCE. The undersigned Drain Layer hereby agrees to all the terms
and conditions set fort .in the petit and atfched thereto.. Applicant has received
Town Street Excavation Pent No . and/or ConnDOT Permit No.
PL:EASELLNOTE:
CBYD No.
IFA SANIIARYSit ER.LATERAL
IS WrrHr If 7S FERT OFA WE
1rM11STBEAIR TESTED
Signed: /` rint Name:
Licensed Drain Layer
Date:�t7
Standard'Fums\P,erM ts�APPUCATION FOR omm LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 7- /6 I
BUILDING ADDRESS 7
STREET
SUBDIVISION: -rp]E,�� F 4�_WAA_/
NORTH ARROW
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STREET ADDRESS SIGNATURE
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TOWN STATE ZIP INSPECTED BY TOWN
2 :7
DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER