HomeMy WebLinkAboutDrain Layers Permits 24 Crestwood Drive (2) 1500016 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 04/07/2015
GIS ID: 24600024 FEE: 60.00
MUNIS APPLICATION# 201500279 EXPIRATION DATE: 05/07/2015
APPLICANT " _ " =„LOCATION
NAME: WASTEWATER SERVICES, INC ADDRESS;" 24"GRESWOOD DRIVE
ADDRESS: 21 COURTNEY DRIVE OWNER:; MILLER ATRICIA E
ELLINGTON, CT 0602-9 24 CRMSTWOOD DRIVE
;outh'Wmdsor,CT 06074
PHONE
WORK DESCRIPTION: NEW SEWER CONNECTION
THE DRAIN LAYER ASSIGNED TO THIS PERMIT HAS A VALID LICENSE ISSUED BY THE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH IN THE ATTACHED`CONDITIONS'. ALI,"WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHA REQUIREMENTS,AND=THE ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED MSPE ED BY
4/7/2015 11:30 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:.1,,r On o1l CONTRACTOR:_SS�P
LOCATION: e9y C C� roc
TYPE OF WORK: "_ .)
DATE INSP NEEDED: 4-1,�'1 S DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS: C A(l- lei?r Al(TU9 s_rPAC
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES WNO
AS-BUILT: �
INPUT: (, DATE: = '
S/molloy/forms 2014 Town of South Windsor INPSECTION REPORT 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVAN AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL -
SOUTH WINDSOR,Cr
FEE$60.00
Location of proposed WorIC: '2 CtZ�sTG„oo7J �7� Lot#
Street No. Sbvd Name
Prernises owned by: `£/2
Name of Firm: S1 !/�s AJ Ins. W .4-77M Phone; %ad ?7f
Ad dress of Finn: 9 c0y1/tf A_ Aj
TYPE OF WORK:
Lay House Drain ;Repair House Drain •
Lay Main;_____; Lay Lateral for CommemlaVIndust iai
' Building of acres
Connection will be made with /p ` s� z 3 s FV C
BMng Wafter Supply: Public Wafter Wdl
Proposed Start Dates Estimated time for completion
ALL WORK TO BE IN ACCORDANCE W1TH.TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA.REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit IS to be issued to the the holder of Drain
Layer's Lim No, 070 7 z Only holders Of P 1, P 7. or W 9 licenses
Will be issued a permit. PERMIT WILL EviRE THIRTY(30) DAYS AFTER
DATE OF ISSUANCE. The undersigned Drain Layer heresy agrees to all the terns
and conditions set forth in the permit and attached thereto, Applicant has received
Town Stred Excavation Permit No. and/or ConnDOT Permit No.
PLEASE NOTE:
CBYID-No. p7QM1 6Zj2 6'L 1FA'SANlTARYSBWER-LA7FRAL
IS WITHIN75fE4T OFA WELL
Signed:— k
9 Print Name. � ??�� AL apt__
Licensed Drain Layer
Dane:_
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: _
BUILDING ADDRESS 2A
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) N C ,TRACTOR' SU RVISOR (PRINT)
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STREET ADDRESS SIGN RE
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TOWN STATE ZIP INSPECTED BY TOWN
� bby$ 3i - DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER