HomeMy WebLinkAboutDrain Layers Permits 673 Griffin Road 1400006 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 04/14/2014
GIS ID: 39000673 FEE: 60.00
MUNIS APPLICATION# 201400370
EXPIRATION DATE: 05/14/2014
APPLICANT LOCATION
NAME: SKIPS SEPTIC 9-ADDRE 613 GRIFFIN ROAD
ADDRESS: 6 NUTMEG DRIVEFRIGEAU RYCHARD R&MARY R
P O BOX 29 = 673 GRfFFIN ROAD
ELLINGTON,CT 06-029 SOUTH VINDSOR,CT 06074
PHONE 860-87i 2332
WORK DESCRIPTION: NEW St�WOR OONNECTION " -
THE DRAIN LAYER ASSIGNED TO THIS''EI VIIT HAS A VALID-LICENSE ISSUED BY THE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH IIQ THIsATTACHED`CONDITI6NS'. ALL CORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHA REQUIREMENTS,AND THE ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
4/14/2014 8:44 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: l OQd CONTRACTOR: S k;1265 Ste__1 C
LOCATION: (6 -73
TYPE OF WORK: NP(A) S_ClA)r V CO nr2e tion
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS: CigCl C4;, G►�'���L SDIZ 3 Feew•
feu• �� �,�� ���� Y hth�.$ � �'� Cl��� c��:�3
SEPTIC TANK PUMPED, SMASHED, FILLED__z WITNESSED ZrYES ❑ NO
AS-BUILT:
INPUT: DATE: 1
W12007 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: 1'73 C17 j ierp Lot #
Street No. Street Name
Premises owned by: `91cf-rtgD rlt C 6 C P A
Name of Firm: y !�Cl�S SC P77C Phone: a'(, o ?7)- 2 33 2
Address of Firm: /�-G ��'X 2 7 7t G ice! G
TYPE OF WORK:
Lay House Drain Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with S7)7 3 T r!V Cr
Existing Water Supply: Public Water Well
Proposed Start Date Z ( �t- Estimated time for completion 4 3 i 4
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 -ZV"' ZuRZ-1--t/z- 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.
CBYD No. TO i 7 4- '16 2 !Z s�
Signed: Print Name: lv#/ ec Iz'
Licensed Drain Layer
Date:— .9 Z /
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: q 3
BUILDING ADDRESS : G 7 3
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT NAME 0' CO RACTOR'S SUPE SOR (PRINT)
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STREET ADDRESS / )141SIGN REDb � 7 3DATE
TOWN STATE ZIP INSPECTED BY TOWN
ao,- 97� —c)3-3,;� DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER