HomeMy WebLinkAboutDrain Layers Permits 135 Sullivan Avenue (3) 1500030 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 06/10/2015
GIS ID: 87300135 FEE: 60.00
MUNIS APPLICATION# 201500648 EXPIRATION DATE: 07/10/2015
APPLICANT ;LOCATION
NAME: HPJ CONSTRUCTION CO ADDRESS: 135 IzULt1VAN AVENUE
ADDRESS: 522 SALMON BROOK STE,T ER. CAST MANAGEMENT LLC
GRANBY, CT 06035 153`CL-AR ST
SQUTH�VNDSOR,CT 06074
PHONE 860-65342- 4-
WORK DESCRIPTION: NEW SEWER CONNECTION FOR SCANEIL PRQI'ERTIz=LOT 2
THE DRAIN LAYER ASSIGNED TO THIS IjVRMIT RASA VALID LICENSE ISSUED I3Y THE S'IATE 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 INSPECTED BY
6/10/2015 10:18 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: 1,5-OY) 1, CONTRACTOR:
LOCATION:
TYPE OF WORK: Ck) ,E4' bj_XleA- 4a/I Pen�O_L�
DATE INSP NEEDED: DATE INSP: / I�s-
INSPECTED BY: 8D
WORK IN
PROGRESS: hl6T ,n s 1l�� 6 ~� _i 30 2cP
a".1 PVL s D re ^ f,/kit
`/1 .o ovel
.T�Az
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C DATE:
S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14
APPLICATION FOR DRAIN LAYER PERMIT - -'
TOWN OF SOUTH WINDSOR
1540 SULLIVAN-AVENUE.
PUBLIC WORKS DEPARTMENT
TOWN HALL.
SOUTH WINDSOR,CT
FEE$60.00
Location of proposes!work, S L9 G L:ot# �
Sheet No. Street Name
'Premisess owned : EGOA �tG- e DPF_ ��
by
Name of Rnn:
Ph
�6a 6�'v rz
Phone:
Address of Firm: 2- �C>A L , I�
P `
TYPE OF WORK:
Lay House Drain Repair House Drain. ;
Lay Mal
rl__�; Lay Lateral for Commerdal/Industrial
Building ✓✓ of awes
Connection will be made with
t
Existing Water Supply: Public Water WTI
Proposed Start Date 2=Estimated time for completion ' '
ALL WORK TO BE IN ACCORDANCE WITH.jDWN OF SOU11j WINDSOR STANDARDS,
k ALL OSHA.REQUIREMENTS AND CONDTRONS ATTACHED TO THE PERMIT
Permit is to be issued to the holder of Drain
Layer's Ucense No. CbZ.C',4��$Z- P7, Only holders of P i, P 7. or W-911oenses
will be issued a permit. PERMIT WILL EXPIRE THIRTY(30) DAYS AFTER
V . DATE OF ISSUANCE. The undersigned Drain Layer hereby agrees to all the Berns
and conditions set forth In the permit and attached thereto.- Applicant has recenneci
Town Sheet Excavation Permit No. and/or ConnDOT Permit No.
R PLEASE NOTE:
' CBYD No. 1FA SANrrMYSAWER LATERAL
IS l nWrN75FEETOFA WELL
rT MUSTBEAIR TESTED
W g �-G f
Si ned: Print Name•
Ucensed Drain Layer
Date:
Sta►&rd FOrM\PeM tsWPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS : -4:� 13S
STREET : S"ilt vim, OENLiF
SUBDIVISION: a-.am e I I fr
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
�Z-2- G Y)
STREET ADDRESS SIGNATUft
06 6 3 4 , f /3��/oez�
TOWN STATE ZIP INSPECTED BY TOWN
,Z-'66-r- � � DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER