HomeMy WebLinkAboutDrain Layers Permits 185 Pierce Road (2) 1300031 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 09/13/2013
GIS ID: 71400185 %% FEE: 60.00
MUNIS APPLICATION# 201301331 %A� EXPIRATION DATE: 10/13/2013
AT
APPLICANT
LOCATION
NAME: THE PEPIN CORPORt fiIDN RE fV11E CE ROAD
ADDRESS: 1006 MILL STREET j yi% =MC IISON BENJAMIN P&GRETCHEN T
EAST BERLIN,CT 02 BINDZUSH LANE
PHONE 1-860-82 5129 / N
CT 06232
WORK DESCRIPTION: NEW SEL ( I �I
��
THE DRAIN LAYER ASSIGNED TO THIS 1 R T I,A A Y �--SS 1 Y F�TATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTf4IE AACH �I A WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARb,A1O_S� QFREaii AT ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
9/13/2013 2:28 PM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: Z,36 I_ CONTRACTOR: Leo f'f n (0
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: -9 /
INSPECTED BY:
WORK IN
PROGRESS: �'���� � S , �Cci� /►1.i w;4 S.'AAaC x'l
a
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
W12007 Town of South Windsor INPSECTION REPORT 07
APPLhCATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVAN AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL
SOUTH WINDSOR,CT
FEE$60.00
Location of ro �,�rr f �e
p posed work. IS I'i Lot #
Street No Street-Name
Premises owned by: I� -e • iM i t t��,
Name of Hnn - �td 1 C� Phone: 940 9-a�r
Address of Firm:_ 6 CDO
TYPE OF WORK:
Lay House Drain : Repalr.House Drain
Lay Main Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
EAsting Water Supply: Public Water_ Well
Proposed Start Date -17-U 3 Estimated time for completion l v
ALL WORK TO BE IN ACCORDANCE WITH.TOWN OF SOUTH WINDSOR STANDARDS,
-
ALL OSHA. REQUIREMENTS AND CONDTiIONS ATTACHED TO THE PERMIT
Permit is to be issued to etf jmv the holder of Drain
Layer's License NO. o ? Onl Y 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. ')-e t3 3W t17 5 PLEASE NOTE:
IFA SAWTARYSEWERMTERAL
IS Nfrmm75 FEE T OFA WEtL
rrMUST BEATR.TESTED
nn
Signed: Print Name:
Licensed Drain Layer
Date:
Standard'Fflrms\Permits\APPUCATION FOR DRAIN LAYERS PERMIT.doc
Molloy, Catherine
From: CallCenter@CBYD2.com
Sent: Wednesday, September 04, 2013 9:37 AM
To: CBYD
Subject: Locate Request-20133601275
(CALL BEFORE YOU DIG - CT) 09/04/2013 09:36:03
-5G -BB -C1 -CW
-GV -OT 3-SW SWINDS -T5
-W3
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***** ROUTINE *****
TIME. .09:35 DATE. .09/04/2013
REQUEST NO. . .20133601275
LATITUDE. .41.8309624 LONGITUDE. .-72.5634768
TOWN. . . . . .SOUTH WINDSOR
ADDRESS. . .185
STREET. . . .PIERCE RD
NEAREST
CROSS STREET. .ELLINGTON RD
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TYPE OF WORK. . . . .EXC TO INST TRENCH FOR NEW SWR LINE
AREA IS MARKED. . .YES
REMARKS:
WORKING ST TO HSE
-------------t- -----------------------------------------------------
START DATE-Y'l 09/07/2013 START TIME. .07:00
CALLER. . . . . . . . . .RICHARD PEPIN
CALL BACK. . . . . . .8-5
PHONE #. . . . . . . . .860-828-5129
FAX #. . . . . . . . . . .N/A
ALT. PHONE #. . . . 04/0
EMAIL ADDRESS. . . ` , ✓✓
CONTRACTOR. . . . . .PEPIN CORPORATION �'1 1� S®�T 6 Z013
CITY. . .DDRESS. . . . . t . . .EASST BERLINSTREET
STATE. . . . . . . . . . .CT GOFA
ZIP. . . . . . . . . . . . .06023
-------------------------------/iMELEMFTI :
---------------------------------
EXCAVATOR DOING WORK. .SAME
ISSUED TO: DATE: : BY:
DATE/TIME ARRIVED: COMPLETED BY:
CALL BACK: 1) DATE: TIME• BY: 2) DATE: TIME: BY:
PERSON CONTACTED: PERSON CONTACTED:
4-0
r ��..
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 9 — /9
BUILDING ADDRESS : 85
STREET Ple,Ir e
SUBDIVISION:
NORTH ARROW
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a_CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
1006 rAt' II S+o
STREET ADDRESS SIGNATU E
DATE
TOWN STATE ZIP INSPECTED BY TOWN
6:�Qd �ldl f/ DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER