HomeMy WebLinkAboutDrain Layers Permits 180 Diane Drive 7
PEERMITRMIT NUMBER TOWN OF SOUTH WINDSOR, CT
DRAIN LAYER PERMIT
DATE: 09/05/2013
GIS ID:28200180
MUNIS APPLICATION# 201301288 AS FEE: 60.00
EXPIRATION DATE: 10/05/2013
APPLICAN`L LOCATION
NAME: RED DOOR CONSTRITwON
ADDRESS: P O BOX 341 _ � � ORES _ I$�Y7IA lE DRIVE
S (l WAYNE L OR
SIMSBURY,CT 0607 CAMIRIDGE DR
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PHONE W S R, CT 06074-1569
860-418831 ,
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WORK DESCRIPTION: NEW SE oh
THE DRAIN LAYER ASSIGNED TO THIS IRS HAS A V`ALEISSUEY TETATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORT I II TL�E�A TAA- W SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARD AI O R �ItEMEN, A1ITHATTACHED CONDITIONS.
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ISSUF4 BY DATE INSPECTED SPECTED BY
9/5/2013 11:40 AM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 3®OOa? 7 CONTRACTOR: 'IZe c (9 CeyLS-'C0G°AeVN
LOCATION: 0\60e
TYPE OF WORK: ifvD Sewe( co yxxnec-Aoy.\
DATE INSP NEEDED: DATE INSP: AS A 3
INSPECTED BY:
WORK IN
PROGRESS: !'V',00 (N�;4"(, 6" sW 33' ;;W ll, 5EW, P( w0A s,�ojE_/r-lac G
C;cx`J Am Tey( /wAr WPL- . jdarZk`^'(.
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES NO
AS-BUILT: `/pj+S �p ��� ?U VRpj i OAX-
INPUT: C/� " DATE: {�1
W/2007 Town of South Windsor INPSEMON REPORT 07
TOWN OF -SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: t? ,- i
BUILDING ADDRESS V�tief
STREET : _ vr
—I— SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME ZTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS SIGNAT E
1 � DATE
TOWN STATE ZIP INSP E Y TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVAN AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL
SOUTH WINDSOR,CT
FEE$60.00
Location of proposed work. t ;c 2 S . " \-Soo Lot#.�....�._
Street No. _Street Name
Premises owned by: ' D <\+ S Z_ cz,on ex
Name of Firm: .Qa C '�c c -�'c Phone: 53 1
Address of Firm: PO box 1-A 1 V(Y)5 o u_f , CTF C:) �0 0�C�
TYPE OF WORK:
Lay House Drain; Repair House Drain.
Lay Main ; Lay Lateral for-Commerdal/Indust ial
Building - of acres
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Connection will be made with �e �r z) 9 - S 35
Existing Water Supply: ' Public Water Well
Proposed Start.Dated - �� Estimated;time for completion
ALL WORK TO BE';N ACCORDANCE WITH TOWN.OF SOUTH WINDSOR STANDARDS,
ALL OSHA.REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to . c LD e0� 11 s �-k c- art the`holder of Drain
Layees License No. 0 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 condition_ s set forth in the permit and attached thereto.. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
PLEASE MOTE:
CBYD No: t 0t (p t)0 rFA.SANITARY SEWER,LA TER 4L
s IS WrTgrN7'S FEET OFA WELL
rTMuSTBEArR TESTED
Signed: Print Name: Sc-o'kA
License ain Layer Pt ,,
Date: Li
Standard Fb msNPerrnits\APPUCATION FOR DRAIN LAYERS PERMMdoe
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