HomeMy WebLinkAboutDrain Layers Permits 9999 Pleasant Valle (2) 1200027 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 06/25/12 =
GIS ID: 72909999 - FEE: 00
MUNIS APPLICATION# 201200835 EXPIRATION DATE: 07/25/12
APPLICANT ;; = LOCATION
NAME: KOVACS CONSTRUCTION SON CORPORATION ADDRESS: PLEASANT VALLEY ROAD
ADDRESS: 297 WHITE STREET OWNER " TOWN(JF SOUTH WINDSOR
DANBURY, CT 06816 1540 SUI LIVAN AVE
S(� JTH WINDSOR,CT 06074
PHONE =
WORK DESCRIPTION: BEARING P�JMP TATIOI+IE R()UT1v I BEET(?F FORCE-MAIN AT
MANHOLE TNTRY" I EFQLLBLyD&P:LEAStfiJT VLy ISO FEE TOWN PROJ
THE DRAIN LAYER ASSIGNED TO THIS PERMIT"HAS A`VALAb LICENSE ISSUED-BY THE-STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH IN THE ATTGHEID`CONDITIONS'. ALL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS ALL OSHA REQITREMENTS,AND TFIE ATTACHED CONDITIONS.
C a �7 ,Y
ISSUED BY DATE INSPECTED INSPECTED BY
6/25/2012 12:08 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /a 000-3>-7 CONTRACTOR:
LOCATION: i Vim S ,On el(k_ zo O �_
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: �7�l
INSPECTED BY: R!�>
WORK IN
PROGRESS: v�®vk �, f-0 t LA&
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: G DATE:
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
Jun, 1. 2012 3:58PM No. 9525 P. 2/2
D R-e—
.P,)o P(O,{'C°� APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVAN AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL
SOUTH WINDSOR, CT"
�S FEE$60.00
Location of proposed work: A(J7' VA"EY J-�, Lot #
S Street No. Street Name
Premises owned by: 16 vvAl J,
Name of Firm: K'V'V A'_C c)f4STA.&7-r0., C-69, Phone:_?0'._743-,�0L-z
Address of Firm: Z 77 WHr n5 s,; DA,ySul,." .7- pCgj0
TYPE OF WORK: 96 P-W►E /S'�-o Y 0/--
Lay House Drain,._ ; Repair House Drain
Lay Main _ ; Lay Lateral for Commercial/Industrial ,
Building of acres
Connection will be made with Docrlcc- i2o,,, /CIA
Existing Water Supply: Public Water 1/ 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 the holder of drain
Layer's License No. Only holders of P-i, 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:
CBY[� No. AFA SANITARYSEWER LATERAL
IS WITHIN 75 FEET OF -WE'LL
IT MUST BEAXR TEST D
Signed:
Print Name -CA1Z la,Y 0 n ',�
Licensed Drain Layer,
Standard Fonn5\Pemtits\APPL1CA70N FOR DRAIN LAYERS PERMIT.doc.
PLUMBING&PIPING t Tl t?CONTRACTOR �.
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011ANGE0. 06471':
LIC./REG ND E IV[ EXPIRES
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f'LM.020274 01 2 t ..
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SIGNED