HomeMy WebLinkAboutDrain Layers Permits 7 Pepin Place (2) 1400046 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 12/03/2014
GIS ID: 70700007 FEE: 60.00
MUNIS APPLICATION# 201401728 = = EXPIRATION DATE: 01/02/2015
APPLICANT , LOCATION
NAME: ATLANTIC EXCAVATOk AIDS TPNLACE
ADDRESS: 363 PARUM ROAD QW 1 T&I—1319 ING CO INC
COLCHESTER, CT 06117
1 }L(: RO( K STREET
�- = ORINI ON, CT 06790
PHONE
As
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WORK DESCRIPTION: NEW SEWER COVNI CJ-IOI
st
THE DRAIN LAYER ASSIGNED TO THIS PERM T-v c A UALII�I 1�ISE ISSUED$Y'.I II S I ATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORT]ftj THE'ATTACHED`CONDITIONS ALL W(? IC SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARb,S,ALL 6§111\REQUIREMENTS;AND THE ATTACHED CONDITIONS.
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ISSUED BY DATE INSP CTED INSPECTED BY
12/3/2014 3:03 PM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: l V 060L/6 CONTRACTOR: A1")rtn+t,�,�j�tc;��4�i0V1
LOCATION: '� �tD � n 7 �
TYPE OF WORK: l V,_-) < C -�, n-e _�F4d v\
DATE INSP.NEEDED: DATE INSP: 92
INSPECTED BY:
WORK IN
PROGRESS: nve 2. �� r
SEPTIC TANK PUMPED,.SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT: y
INPUT: DATE:
S/molloy/forms 2014 Town of South Windsor INPSEC HON 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: '7 `a
Street No. Shmat Name
Premises owned by: :e1,n n
Name of Firm: jr a�Az'� Phone: a
Address of Firm:
TYPE OF WORK:
Lay House Drain Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with S5 Zelf 3 5- Aac,
ExistingSupply.Water Public Water i Well
Proposed Start Date a c Estimated time for completion skis
ALL WORK TO BE IN ACCORDANCE WTTH.TOWN OF SOUTH WINDSOR STANDARDS,
Ci EM AND NI[` A'1-PA7`LJCI%TA TtlC I l=nhArr
Permit is to be issued to.�� .c ,�_ c'.�, %P,,d a holder of Drain
Layer's License No."o s4g y-,P 7 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.
PLEASE NOTE:
CBYD No. . �3/� rf�d / �6 IFA SAN,ITARYSVWER-LATERAL
rS MVITHIN75 FEE T OF WELL
IT MUST BEAIR TESTED
Sign Print Name: a c
Y
Licensed Drain La
Date:
Standard FormAPermits\APPLICAIION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: l,Z
/Y// y
BUILDING ADDRESS 77
STREET
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SUBDIVISION: � � •�
NORTH AR OPAXS
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CONTRACTOR NAME OF NTRA TOR' SU
(PRINT (PRINT)
STREET ADDRESS SI RE
7�1 ` DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER