HomeMy WebLinkAboutDrain Layers Permit 355 Abbe Road 1400045 TOWN OF SOUTH WINDSOR, CT
PENT NUMBER DRAIN LAYER PERMIT
DATE: 11/26/2014
GIS ID: 00900355 FEE: 60.00
MUNIS APPLICATION# 201401702 EXPIRATION DATE: 12/26/2014
APPLICANT - - LOCATION
NAME: WASTEWATER SERVTGES, INC` ADDRESS." 35S=ABBE ROAD EXT
ADDRESS: 21 COURTNEY DRIVE - OWNER: B LEKEA! GREG&MIRA
ELLINGTON,CT 0609 355 HE ROAD EXT
" SOUTIT rDSOR,CT 06074
PHONE -
WORK DESCRIPTION: NEW SEW - k ONNECTION
THE DRAIN LAYER ASSIGNED TO THIS 1?ERMIT HAS A VALID LICENSE ISSUEDBYTHE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTT-I INTHE ATTACHED`CONDITIONS'. ALL W6iK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHA REQUIREMENTS,AND THE ATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED - -__ _ _ INSPECTED-B-Y
2014 12:02 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: 1,Utl tx,,a4 Se- v I 60, S
LOCATION: .SS Abbe V-rl
TYPE OF WORK: tyP Sewer Cnrin&abon
DATE INSP.NEEDED: DATE INSP: > - '
INSPECTED BY: �
WORK IN
PROGRESS: (' �., . ` .'
A '� /11:4, 3'14 ed�D n_a ,-r—
SEPTIC TANK PU QED, SMASHED, FILLED `�I WITNESSED TES ❑ NO
AS-BUILT: ,
INPUT: C` DATE:
S/molloy/forms 2014 Town of South Windsor INPSECIFION 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: 7S-5- t9 Z79E Tzp Ex T Lot#
Street No. Street Name
Premises owned by: GP-Sc z C kFw /c —
Name of firm: sK rPs Phone: ?6o 87 z 3 3 2
Address of Firm: 21' O UX-7 i f y (3 rz F-4-4-/Ai G-nA f
TYPE OF WORK:
Lay House Drain .; Repair_House Drain
Lay Main ;, Lay Lateral for Commerdai/Industrial
Building of - aces
Connection will be made with �0 4 sD� 3 s ?Vc
Existing Water Supply: Public Water Well
Proposed Start Date i2-Z-/� Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH.TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REOUIREMENTS AND C0111r)mn 1q ATTA[NFn Tn TNF PERMIT
Permit is to be issued to the holder of Drain
Layer's License No. o Z o '7 2 2 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 terns
...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. �°/4" �r10 Z4o6 PLEASE NOTE:
IFA SANITARYSt-WER.LATERAL
IS W.ITHIN75 FEET OF WELL
TT MUST BEAIR rESTED
Signed. //— Print Name: `1#Vk/t1 k �
censed Drain Layer
Date:
Standard FormsWermits\APPLICATION FOR DRAIN LAYERS PPERMIT.doc
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