HomeMy WebLinkAboutDrain Layers Permits 25 Blue Ridge Drive (2) 1400022 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 07/07/2014 _ 1 Q P3
GIS ID: 11700025 ��� ' Aw 9
FEE: 60.00
MUNIS APPLICATION# 201400887 3 EXPIRATION DATE: 08/06/2014
APPLIC LOCATION
NAME: JDC ENTERPRISES D L E RIDGE DRIVE
ADDRESS: 420 JOHN FITCH B A-s 4 EVA Y
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SOUTH WINDSOR 6 �� L RIDGE DRIVE
yam . s INDSOR,CT 06074
PHONE 860-66 - 0 . -
WORK DESCRIPTION: NEW S C may-
THE DRAIN LAYER ASSIGNED TO THI I �S ASS _v STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FOR I�� - ORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STAND � I aA' E ATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED-BY
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1 /2 060 CONTRACTOR: D C.
LOCATION: 121 &Ge
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TYPE OF WORK: Lee a se
DATE INSP NEEDED: DATE INSP: 7
INSPECTED BY: BD
WORK IN
PROGRESS: 1*A���a.c��- �.�� `' !`'tic. Dig s� J�iow.
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SEPTIC TANK PUMPED, SMASHED, FILLED 'WITNESSED ffrfES ❑ NO
AS-BUILT: '
INPUT: � DATE:
S/2014 Town of South Windsor INPSECTION REPORT 14
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:a 15- QL !/c 110a !b &�E 4 #
Street No. Street Name
Premises owned byvlVl elf,4 6'Z 4- G=04 AYA j 2 ]ZA)
Name of Firm: Phone
Address of Firm:_'?'-'dT IS(- c--21 aO� y s'
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with .S'�� 2 .- `S'
Existing Water Supply: �fPublic Water Well
Proposed Start Date �/ -1f` Estimated time for completion l�
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 J�s �a the holder of Drain
Layer's License No.GA 023 3 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�-U/
Signed: Print Name:
Licensed Drai Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMrr.doc
Molloy, Catherine
From: Cal[Center@CBYD2.com
Sent: Tuesday, July 01, 2014 12:53 PM
To: CBYD
Subject: Locate Request-20142701602
(CALL BEFORE YOU DIG - CT) 07/01/2014 12:52:45
-5G -C1 -CW -OT
4-SW SWINDS -T5
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*** REMOTE BATCH ENTRY ***
***** ROUTINE *****
TIME. .12:53 DATE. .07/01/2014
REQUEST NO. . .20142701602
LATITUDE. .41.8272808 LONGITUDE. .-72.5431604
TOWN. . . . . .SOUTH WINDSOR
ADDRESS. . .25
STREET. . . .BLUE RIDGE DRIVE
NEAREST
CROSS STREET. .DEERFIELD LANE
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TYPE OF WORK. . . . .SEPTIC TO SEWER CONVERSION
AREA IS MARKED. . .YES
REMARKS:
WORKING IN THE REAR OF THE HOUSE IN THE CENTER TO THE RIGHT SIDE OF THE HOUSE IN THE
BACKYARD
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START DATE. . . . . .07/07/2014 START TIME. .08:00
CALLER. . . . . . . . . .ANN BUCCHERE
CALL BACK. . . . . . .
PHONE #. . . . . . . . .860-667-4800
FAX #. . . . . . . . . . .
ALT. PHONE #. . . .
EMAIL ADDRESS. . .JDCENTERPRISES@AOL.COM
CONTRACTOR. . . . . .JDC ENTERPRISES, INC.
ADDRESS. . . . . . . . .420 JOHN FITCH BLVD., PO BOX 905 CITY. . . . . . . . . . . .SOUTH WINDSOR
STATE. . . . . . . . . . .CT
ZIP. . . . . . . . . . . . .06074
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EXCAVATOR DOING WORK. .JDC ENTERPRISES, INC
ISSUED TO: DATE: TIME: BY:
DATE/TIME ARRIVED: TIME LEFT: COMPLETED BY:
CALL BACK: 1) DATE: TIME: BY: 2) DATE: TIME: BY:
PERSON CONTACTED: PERSON CONTACTED:
1
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 7_- + 7
BUILDING ADDRESS .11E.25"
STREET 61 L&e- OQ;A,p D r;vc_
SUBDIVISION:
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CONTRACTOR ( INT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
Li I DATE
TOWN
I , STATE ZIP INSPECTED BY TOWN
q � DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER