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HomeMy WebLinkAboutDrain Layers Permits 178 Graham Road 1300035 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 10/11/2013 GIS ID: 37500178 FEE: 60.00 MUNIS APPLICATION# 201301475 EXPIRATION DATE: 11/10/2013 APPLICANT = LOCATION NAME: JAMES THROWE DBA ADDRESS- 178 GRAHAM ROAD ADDRESS: 97 RIVERSIDE DRIV11 �WIER GIROUXCONSTRUCTION VERNON ROCKVILIlk,C'T'06066J , : �4 SST VIEW DRIVE %' $GOAD BROOK, CT 06016 PHONE 860-289 6045-- 1 = WORK DESCRIPTION: NEW SEWEICONNCTIO THE DRAIN LAYER ASSIGNED TO THIS PERMITHAS A VAL1D IINBE ISSUEID$Y THE SIATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FORTH--,ITHE"ATTACHIxI] CONiLONS'"AF1 VVQRK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDARDS ALL OSHA REQUIiEMENTS AND THFfATTACHED CONDITIONS. c NO�� ISSUED BY DATE INSPECTED INSPECTED BY 10/11/2013 9:29 AM TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT N©.: �b CONTRACTOR:�aS rDu 9P LOCATION.: 11 &ca,lad rc, {� TYPE OF WORK: Sa w� C�Y)1re 6J 0 h DATE INSP NEEDED: DATE INSP: INSPECTED BY: Q b WORK IN PROGRESS:- SOL", -meti� sad fe tv► f'VC L) -�fcr"' & fro Svc"/o ill i/� � �' C.-+. SIt j SEPTIC TANK PUMPED, SMASHED, FILLED - WITNESSED ❑ YES' ❑ NO AS-BUILT: INPUT: W� DATE:--jploill V,1,2007 Town of South Windsor INPSECTION REPORT 07 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: 17 &IOA u n Lot# Street No. Street Name Premises owned by MA r s.U Name of Firm: Address of l=irm ,7e)W rs, L TYPE OF WORK: Lay House Drain � Repair House Drain Lay Main, _ m ; Lay Lateral for Comercial/Industrial Building _ of acres Connection will be made with p> " Existing Water Supply: Public Water Well Proposed Start Date I S�am_Estimated time for completion S G c /3 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 s the holder of Drain Layer's License No. �(i6 3 8'i Only holders of P-1,°P-7 or W-9 licenses will be issued a permit PERMIT WILL EKPIRE THIRTY(30)DAYS AFTER DATE OF ISSUANCE. The undersigned Drain Layer hereby agrees to all the terms and conditions set forth in the p erm.it and attached thereto. Applicant has received Town Street Excavation Permit No. and/or ConnDOT Permit No. PLEASE NOTE: CBYD No. a0l3 9(00 72 IFA SANITARYSEWERLATERAL IS WITffr f 75 FEET OFA WELL IT M11ST BEAIR TESTED .Signed: Print Name: ry Licensed Drain Layer Date: /0 G c.1 / 3 Standard formsTermits\APPLICATION FOR DRAIN LAYERS PERMIT.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: � c_r BUILDING ADDRESS / -7? STREET : &-rc'k&v►-► 4 - SUBDIVISION: %eC LA o c S °2e 5�tb�`��s�®n NORTH ARROW , t � ! I i 1 Poi �til • I CONTRACTOR (PRINT) ) NAME 0 CONTRACTOR'S UPERVISOR (PRINT) 5j Ri ve�i c� o c STREET/ADDRESS SIGNA E f /Y,rAein C 1 � �i _ %0!/ f 13DATE TOWN STATE ZIP INSPECTED BY TOWN DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER