HomeMy WebLinkAboutDrain Layers Permits 187 Frazer Fir Road (2) 1300022 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 08/20/2013 „-
GIS ID: 34430187 =_ FEE: 60.00
MUNIS APPLICATION# 201301174 �= " EXPIRATION DATE: 09/19/2013
APPLICANT`'' LOCATION
NAME: EAGLE EARTHWORI SF,RV 1DRESA& NfVR ER FIR ROAD
ADDRESS: 101 N MOUNTAIN R( A Q� EAN�IAINO BUILDERS INC
CANTON, CT 06019 , -" 40Q CHAPEL ROAD
PHONE 860-693 2027 1 f
WORK DESCRIPTION: NEW SEWED- O*ECTICfi
THE DRAIN LAYER ASSIGNED TO THIS IRIIT S At�LILII�ISSUED 13Y T ETATE AND HEREBY AGREES TO ALL AS
THE TERMS AND CONDITIONS SET FORTINfiHE AT�tC�I� Q1IT I ? "WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARD IL A OS3IRQEIREMED1 A18IITI ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
8/20/2013 10:36 AM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /�00Q, CONTRACTOR:_ 00rl9
LOCATION: 187 rid ZlPr r
TYPE OF WORK: 52 wer coV,nec*D✓1
DATE INSP NEEDED: DATE INSP: 942 0113
INSPECTED BY: Bf�
WORK IN
PROGRESS: 6 fyc SDP-
4
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: 0AA__ DATE: a
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR DRAIN LAMER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVAN-AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL
SOUTH WINDSOR,CT
FEE$60.00
-Location.of ro 19 +'7 posed work._ �7 _ z`erF'Y !g Lot#
Street No. Street Name
Premises owned by fmt-,7 r) ,�u► .P '
Name of Finn: �,oIS _ A Phone:� �
Address of Fir m: ;
TYPE OF WORK:
Lay House Drain_ Repair House Drain.:
Lay Main_------; Lay Lateral for Commercial/Industrial
Building of apes
Connection will be made with
Existing Water Supply: Public Water t Well
Proposed Start Date �Estimated time for completion.
ALt.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 o !G/ i .n
the holder of Drain
Layer's Ucense No. Only hotd��rf P-1, P 7 or W 9 licenses
will be isst� permit. PERMIT WILL EXPIRE'I'It1l1f(30)`DAYS AFTER
DATE OF iSSU'AICE The undersigned Drain Layer hereby agrees to all the terms
and conditions set forth.in the. it and a ivied
attached s received ed thereto.. Applicant has
Town Street Excavation Pent No. and/or ConnDOT Permit No.
PLEASE NOTE
CBYD No.
IFA SANITiQRYSRLVER-LATERAL
I FA WEE4
S WI�''ffIN75�L�ET O
rrNIIST AVEArR TESTED
Signed:
Print Name;. Ck
i Wi Licensed.Drain Layer
Date: /
standard'FOrms\P,eM ts�APPUCATION FOR DRAIN LAYERS PERMrr doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: �'�®" `�
BUILDING ADDRESS
STREET : f;7q
SUBDIVISION: Dof --r-rec T-rrr/t-i
NORTH ARROW
-77
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CONTRACT (PRINT) NAME OF C TRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS SIGNA U IT
DATE
TOWNSTATE ZIP INSPECTED BY TOWN
X C> 6"? DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER