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HomeMy WebLinkAboutDrain Layers Permits 344 Beelzebub Road (2) 1400035 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 09/24/2014 GIS ID: 09000344 MUNIS APPLICATION# 201401342 FEE: 60.00 EXPIRATION DATE: 10/24/2014 APPLICANT LOCATION NAME: SKIPS WASTEWATER ADDRESS 344-BE8LZEBUB ROAD ADDRESS: 21 COURTNEY DRIVE OWNER KITCHIN DONALD W JR&PHYLLIS I ELLINGTON, CT 06029; 344 `BEELZEBUB ROAD PHONE 2332 SOUTH WI 860-875- NDSOR,CT 06074 WORK DESCRIPTION: NEW SEWER-CONNECTION THE DRAIN LAYER ASSIGNED TO THIS PERMIT HAS A VALID LICENSE ISSUED BY THE jTATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FORTH IN THE ATTACHED`CONDITIONS'. ALL WORK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHA REQUIREMENTS,AND THE ATTACHED CONDITIONS. ISSUED BY DATE INSPECTED .mow 9/24/2014 12:31 PM INSPECTED BY -- --- -------- TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: ddD � CONTRACTOR: GtASkfl)aVe--l_ LOCATION: �/� 6ee l Z(fc u b goad TYPE OF WORK: I )ew -'�p we(Z (30 o n-ee-li o n DATE INSP NEEDED: DATE INSP: & l INSPECTED BY: WORK IN PROGRESS: SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: Ll�' INPUT: ON. DATE: 1 S/molloy/forms 2014 Town of South Windsor INPSECIZON REPORT 14 APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR 1540 SULLIVAN AVENUE PUBLIC WORKS DEPARTMENT TOWN HALL SOUTH WINDSOR,CT FEE$60.00 Location of proposed work: 3i q FiE L z ' f u 13 Lot# Street No. Street Name . Premises owned by: A/� cB7Z uc Name of Firm: _rZ� _phone: . ? o — 7 7 3 3 2- Address of Firm Z Ir C,cM/r-r)v C y 2 c L ,j G TYPE OF WORK: Lay House Drain_? ; Repalr.House Drain Lay Main ; Lay Lateral for Commercial/Indusbial Building of acres Connection will be made with vc s':�X- 3 r Existing Water Supply: Public Water Weil Proposed Start Date 2�i Estimated time for completion q-Z�-�� ALL WORK TO BE IN ACCORDANCE WITH-TOWN OF SOUTH WINDSOR STANDARDS, ALL.OSHA REQUIREMENTS AND CONDTRONS ATTACHED TO THE PERMIT Permit is to be issued to the holder of Drain Layer's License No. 2 v 1?,?z r 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. 2 0 l ¢ 3 SO 7 Z o PLEASE NOTE: CBYD No. � IFA SANITARYSOWER LATERAL IS WrrHIN7SFEET OFA WELL r.rMUST BEArR TESTED Signed: Print Name: % �y,41-k'E7Z- Licensed Drain Layer Date: 9- `�- standard FOrMs\Permits\APPLICATION FOR DRAIN LAYERS PERMrr doc BE E BU B G . � 720t © , G ` 4 18 c P7� SNET W D..... SNET gS v #3034 0 S ET#30 3 102.08 F.M. 84 FRAME � it352 , t� •� , ZORY FRAME � , Q- •1 D JR• �11F 90NA4� PNYL.ISS� N p�T/ 'OrCHEN 4RDENGN AN���p E A F DO 6; (:P LAT. >,TA, t0 r 82.0 �EANN� M V-0' LONG ,l 5.o' bE e� ,NNpN `�► G w C1�1MN r`4,5+1�G«1 v `� TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: 09 15-- Z.o t4 BUILDING ADDRESS 3 4-4 ee Ise L,Ui� STREET iZd SUBDIVISION: NORTH ARROW Li3 f ! I Iz Z, i _ 1 i i 3 ' � I II : CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPE ISOR (PRINT) `Z 9-tl 4 STREET ADDRESS SIGNATURE 00, &L a6,0 Z`t DATE TOWN STATE ZIP INSPECTED BY TOWN f 60- �,�t-Zgld DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER