HomeMy WebLinkAboutDrain Layers Permits 470 Governors highw 1300030 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
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DATE: 09/13/2013
GIS ID: 36900470
i FEE: 60.00
MUNIS APPLICATION# 201300918
EXPIRATION DATE: 10/13/2013
APPLICANT LOCATION
NAME: SADOW EXCAVATI
D RE 4kOERNORS HIGHWAY
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ADDRESS: 115 ELDREDGE ROA7 PROPERTIES LLC
WILLINGTON„CT ObW HILL ROAD
al ow I SAWA-
PHONE 860-429 769fliff V INDSOR,CT 06074
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WORK DESCRIPTION: NEW SEA 'CONNNE
THE DRAIN LAYER ASSIGNED TO THIS I R T 3' W At? �aS-SU II.Y Y HF TATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTf1�TE` ItCCH ITIQ ALA WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARI a AI _mq RE A fiI TI ATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED BY
9/13/2013 9:08 AM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1 3o0030 CONTRACTOR: Sa d,0(_4
LOCATION: L-1 "7 0 At Ao( n0(-
TYPE OF WORK: NyLo awQA ('� there j ct 1-6v1 yl ea*0n
DATE INSP NEEDED: DATE INSP: q1f.2//4
INSPECTED BY: 06b
WORK IN
PROGRESS: o h I b 3 cli.-
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: .DATE: i 1
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: L
ot #
Street No.
Street Name
Premises owned by: &D S
Name of Firm: Saeflc� Phone: �bo�f z$ZoZ:Z.
Address.of Firm; Nt,J�ttc �n a62r�7
TYPE OF WORK:
Lay House Drain
Lay Mai Repair House Drain
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Lay Lateral'for Commercial/Industrial
Building_ of. acres
Connection will be made with
Existing Water Supply: Public Water "A, Well
Proposed Start Date 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
Layer's Ucense No. the holder of Drain
will be issued a Only holders of P-1, P-7 or W-9 licenses
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. �3 as ITT and/or ConnDOT Permit No.
CBYD No. o t 3 3 W - �
Signed:AA � ✓ Print Name:_
Licensed Drain Layer
Date: `1 1147
Standard Forms\Permits\APPLIcATION FOR DRAIN tAYERs PERmu.doc
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 3
BUILDING ADDRESS # y 7 8
STREET : Wi � Loveetior.5 4+ hLo
SUBDIVISION: 6
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS SIGNATURE >
Litew►kkd�4N C_-� , p��7 ' I�//Z DATE
TOWN STATE ZIP INSPECTED BY TOWN
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TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER