HomeMy WebLinkAboutDrain Layers Permits 34 Blue Spruce Road (2) 1400020 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 06/23/2014 '
GIS ID: 11800034 s j FEE: 60.00
MUNIS APPLICATION# 201400810 = EXPIRATION DATE: 07/23/2014
APPLICAI- �� LOCATION
NAME: EAGLE EARTHWO] R )RELL SPRUCE ROAD
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ADDRESS: 101 N MOUNTAIN I = NAIRINO BUILDERS INC
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CANTON, CT 0601 f0 CHAPEL ROAD UNIT 3F
zmoommaj j % LI INDSOR,CT 06074
PHONE 860-69207 _
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WORK DESCRIPTION: NEW S"—
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THE DRAIN LAYER ASSIGNED TO THIARE I'1gixs t E SSiIEH 3 TI STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FOR` G THE-A-TA2Ij1DFT4 tI, bRK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDAUK l&L OS". ATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED BY
6/23/2014 2:37 PM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: q Dbod b CONTRACTOR: Za& &a( hi_Vwlks
LOCATION: 3`{ L per (�, •bQ
TYPE OF WORK: LO
DATE INSP NEEDED: DATE INSP: G1 �2 lly
INSPECTED BY: Rh
WORK IN
PROGRESS: (_� �7�tct t f^z* ;'l s 6 oc Sb M 3 S r-n' , Si,S
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT: ✓
INPUT: DATE:
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
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: ,31 Me- 4?rve-�—* �� Lot # > o
Street No. Street Name
Premises owned by: 6-4
Name of Firm: 04D Ale, 4 0— Phone: 01
7
Address of Firm:- � �t/ { J/�l �2/' ��Y, 9y, �' 06'6 j of
TYPE OF WORK:
Lay House Drain_; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water_ Well
Proposed Start Date Estimated time for completion A017
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 1�jf(�r e,( 6 the,holder of Drain
Layer's License No. Only holders of P-11 P77 or W-9 Licenses
will be issued a permit. PERMIT WILL EXPIRE THIRTY(30),QAYS AFTER
DATE OF ISSUANCE. The undersigned Drain Layer hereby agr 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.
Signed: &"/V_F�mt Name: 1C'4z6 celeo)'yt
Licensed Drain Layer
Date: 0 ` C
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
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I CONTRA OR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
161 NeCA
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TOWN STATE ZIP INSPECTED BY TOWN
A0 — 6 9,j-- �'7 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER