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HomeMy WebLinkAboutDrain Layers Permits 18 Blue Spruce Road 1400028 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 08/07/2014 GIS ID: 11800018 ,. FEE: 60.00 MUNIS APPLICATION# 201401085 EXPIRATION DATE: 09/06/2014 APPLICAI� = 77 LOCATION NAME: EAGLE EARTHWOI ��RX� „" A.DDRE : 1---& SPRUCE ROAD IF OF ADDRESS: 101 N MOUNTAIN RO OWNER `'MAIy TARINO BUILDERS INC CANTON,CT 06019. 400-CH 'EL ROAD UNIT 3F OiLIJINDSOR,CT 06074 PHONE 860 69T 20T7 = , WORK DESCRIPTION: NEW SH�BCbNCTION THE DRAIN LAYER ASSIGNED TO THIS ?EI IIT HAS A VA�,ID LICENSI ISSUEDBY TH STATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FORTlI&i a -AT r H9D-`QQNDI"TIQ ")ML VORK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDARDS L bSHA REQUIREMENTS,Anil)TITS ATTACHED CONDITIONS. ISSUED BY DATE fNSMCTED INSPECTED BY 8/7/2014 8:45 AM TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.:_� ` D CONTRACTOR: ij`� )e LOCATION: TYPE OF WORK: Af co S'2,� Ccp VnY-v r-j12)n DATE INSP NEEDED: DATE INSP:- j1�'_'� INSPECTED BY: r,'l)La WORK IN PROGRESS: �' h c iA�'I�I1 �� �/ ►���� U�� O�f�[�'C:7j�� SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: � S/2014 Town of South Windsor INPSEMON 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: 12 g I"e '!!� Lot # _ Street No. Street Name Premises owned by: jL4q ahaymo &Meia Name of Firm: a le, G r4 tywzk- 50-tAc" Phone: 4'Q 77 Address of Firm:/6l I,*Pk M /t R �afan TYPE OF WORK: Lay House Drain; Repair House Drain ; Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with C P v c Existing Water Supply: Public Water Well Proposed Start Date 4)011-) 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 A a 4,*r - t/ the holder of Drain Layer's License No. .� 7 010 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. ©l � � 007Z/7 Signed: kyle l Print Name: �`^� Licensed Drain Layer Date: r-c-;20/`/ Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: Lq BUILDING ADDRESS _ 42-0j� STREET � 4 } SUBDIVISION: NORTH ARROW 'A'k-- fill" j ! CT i - -fi - I-- 16 - ; 1 F i _ t I CONT TOR (PRINT) T- NAME Or,CONTRACTOR'S SUPERVISOR ( RI T) &10 C-4 STREET ADDRESS Q, SIG E DATE TOWN STATE ZIP INSFFErTED BY TOWN DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER