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HomeMy WebLinkAboutDrain Layers Permits 20 Henry Road 1400019 TOWN OF SOUTH WINDSOR, CT PENT NUMBER DRAIN LAYER PERMIT DATE: 06/19/2014 GIS ID:41400020 FEE: 60.00 MUNIS APPLICATION# 201400780 EXPIRATION DATE: 07/19/2014 APPLICA rR LOCATION NAME: SMITH MECHANIC D E Y ROAD ADDRESS: 195 UNION STREE >=I F ER TIERRA L& MANCHESTER,CT = " ' EN Y ROAD INDSOR,CT 06074 PHONE 860-64 3 WORK DESCRIPTION: NEWS r THE DRAIN LAYER ASSIGNED TO THI E I S? 4S STATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FOR H - RK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STAND A I ATTACHED CONDITIONS. Caka "M 19SUEIJ BY BATE SPE TED INSPECTED BY 6/19/2014 3:37 PM ftw fA '4 TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: 1100019 CONTRACTOR: SMAt-A nPe-lWn Ca Z L G LOCATION: a D f4e h (L y d TYPE OF WORK: 11 ncj Sa-w-eA, C© vl o ecY4 611 DATE INSP NEEDED: DATE INSP: INSPECTED BY: G. WORK IN PROGRESS: t3 G—��- �� n f r`e- b f��(:I '�� C.11, "s t n .(ro►�,f ` b�c�' 6/a.��Iv P :7 ��641 eeh oid F ph 1 in, LO&Lt /G' "u jer 41 l feff 6/44n su/ SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: C'V� 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: .2 e) Lot # Street No. Street N me Premises owned by: Tt e,V A S Name of Firm: M a C fj�CA C C Cam- Phone: B"�d,,�-d 7U Address of Firm: 19 5- u.,j co�1 J4 rM It,JOA e- sue✓' (--t o('y qZ TYPE OF WORK: / Lay House Drain ✓ ; Repair House Drain ; Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with r� Lff 3 S Existing Water Supply: Public Water Well_t,�' Proposed Start Datejo Estimated time for completion L a,5PL� 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 '13A rr a �M s`1t the holder of Drain Layer's License No. 0 ,20g!?6 S 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. 01 y2!j 019 2 Signed:, Print Name: f Li se Drain Layer Date: � 1l2y/ I Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc Drabek, Bernard From: CallCenter@CBYD2.com Sent: Tuesday, June 17, 2014 2:53 PM To: CBYD Subject: Locate Request-20142501923 (CALL BEFORE YOU DIG - CT) 06/17/2014 14:52:32 -5G -Cl -Cw -J1 -OT 3-SW SWINDS -T5 -------------------------------------------------------------------------- ---- *****ROUTINE ** ** ---- -- - - -- -- TIME. .14:52 DATE. .06/17/2014 REQUEST NO. . .20142501923 LATITUDE. .41.8627991 LONGITUDE. .-72.5514494 TOWN. . . . . .SOUTH WINDSOR ADDRESS. . .20 STREET. . . .HENRY RD NEAREST CROSS STREET. .GRAHAM RD -------------------------------------------------------------------------- TYPE OF WORK. . . . .EXC TO INST SEWER AREA IS MARKED. . .YES REMARKS: WORKING FROM THE CURB LINE ALONG RIGHT SIDE OF PROP TO THE BACK -------------------------------------------------------------------------- START DATE. . . . . .06/20/2014 START TIME. .07 :30 CALLER. . . . . . . . . .BARRY SMITH CALL BACK. . . . . . . PHONE #. . . . . . . . .860-209-7470 FAX #. . . . . . . . . . . ALT. PHONE #. . . . EMAIL ADDRESS. . . CONTRACTOR. . . . . .SMITH MECHANICAL LLC ADDRESS. . . . . . . . .195 UNION ST CITY. . . . . . . . . . . .MANCHESTER STATE. . . . . . . . . . .CT ZIP. . . . . . . . . . . . .06042 -------------------------------------------------------------------------- EXCAVATOR DOING WORK. .SAME 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 y TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS STREET SUBDIVISION. NORTH ARROW i i 1 i gMq CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT) l q5 (d n 1 ah STRE�EI,T� ADDRESS SIGNATURE 64. 04ey CT C)6'®V d'-, 7 DATE TOWN STATE ZIP INS CTED BY TOWN DATE TELEPHONE -NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER i spf�,Zl, 74/1 ----- -- - --- r �/ 1 U C S c> 2 3 i -------------