HomeMy WebLinkAboutDrain Layers Permits 193 Foster Road (2) 1300040 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 11/18/2013 — ,
GIS ID: 33300193 — — FEE: 60.00
MUNIS APPLICATION# 201301699 EXPIRATION DATE: 12/18/2013
APPLICANT LOCATION
NAME: KLOTER PLUMBING CO J )RESS f-9 FOSTER ROAD
ADDRESS: 26 SADD MILL ROAD ,OWNER == BOLLESGENE F JR&JEWEL
ELLINGTON, CT 06029 = 193 FOSTER ROAD
' SOUTH,WINDSOR,CT 06074
PHONE
WORK DESCRIPTION: RELOCATE I� --r] G- SA1 FARY SEWBI AT 2AL
DUE TO BUDDING ADDI I(� I CQ FLI—
THE DRAIN LAYER ASSIGNED TO THIS IER1vIIT HAS A VAL D LIC�N�E ISSUEI5-33Y THE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FOR TI4IAd-HE ATTACH D <3NDITIONS' ,-AI I OI IC SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS ALA -SHA RI[tT 1ZEI IENT'Ss ANI THE ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
I 1/18/2013 11:23 AM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR:
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: 6 D
WORK IN
PROGRESS: Co,41vr c JW tZe loc4AJ Sc
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SEPTIC TANK PUMPED MASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT:_ 11'� DATE:
wJ/2007 Town of South Windsor INPSECTION REPORT 07
dPOC.yl Zfl13o�G99t- �� ' 13Ooo¢
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
I540 SUU IVAN AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL.
SOUTH WINDSOR,CT
FEE$60.00
-Location of proposed work: 1 raS'r2 2 Lot#
Street No.. Street Name
Premises owned by: - e fV. C ( S
667661 . Name of Firm: K l o- z (Z, ? )v (Y� Phone:
Address of Hirm: ►'VI t I r Y I `f� c
TYPE OF WORK: /
Lay House Drain------; Repair.House Drain ✓
Lay Main : Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with �D U.CSAP r
Existing Water Supply. Public Water �� Weil
Pro Start Date 1 L l2 , 3 i I N 2
Posed Estimated time for completion
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 the holder of Drain
Layer's license No.. 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 conditions set forth in the permit and attached thereto.. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
PLEASE NOTE:
CBYD No. Qc2l lFA SANITARYSEWER LATER4L
IS WITffIN7S FEE T OF WELL
IT MUST BEAIR TESTED
Signed:9 - Print Name:
Licensed Drain Layer
Dater
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS C� 3 5 ) i R
STREET : 6 6 ►`
SUBDIVISION:
NORTH ARROW "� w.'b
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
0 � N I 0
STREET ADDRESS SIGNATURE
�j DATE
TOWN/ STATE ZIP INSPECTED BY TOWN
CIA �1 `t ' r DATE
TELEPHONE NUMBER rj 3 i
WHITE - TOWN IPINK - CONTRACTOR YELLOW - CONSULTING ENGINEER % DEVELOPER