HomeMy WebLinkAboutDrain Layers Permits 125 Miller Road 1500028 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 06/09/2015
GIS ID: 59700125 FEE: 60.00
MUNIS APPLICATION# 201500685 EXPIRATION DATE: 07/09/2015
APPLICANT LOCATION
NAME: JAMES THROWE DBA ADDRESS: 125 MILLER ROAD
ADDRESS: 97 RIVERSIDE DRIVE OWNER: RSK-KELLCO
VERNON ROCKVILLE, CT 06066 1744ELLINGTON RD
SOUTH WINDSOR,CT 06074
PHONE 860-289-0095
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'. ALL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHA REQUIREMENTS,AND THE ATTACHED CONDITIONS.
7/1/2015 2:12 PM ISSUED BY DATE INSPECTED MSPE TED BY
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:; /,s'00 CONTRACTOR:Ed 4-W4 'MaXl 0 � S
LOCATION: /d ,6` 1�')I I I1�r � C�
TYPE OF WORK: n taC'7 U h
DATE INSP NEEDED: DATE INSP: 7--2 -15—
INSPECTED BY: 69
WORK IN
PROGRESS: eyc- S t�l P- 3 r�o
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SEPTIC TANK PUMPED SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: s
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,CT
FEE$60.00
5
. Location of proposed work: !as ir,►11�r` Lot#_=
Street No. Street Name
'Premises owned by: "
Na 4, �2: � olS
me of Firm:.. � Gn�i .rM.c,�n. !L ��.C.LLPhone:
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: Address of t=irm: .3� e
TYPE OF WORK:
Lay House Drai • Repair House Drain
Lay Main----; Lay Lateral for Commercial/Indusbial
Building of awes
Connection will be made with S,n 3S
Existing Water Supply: Public Water Well
1
Proposed Start Date ��� is Estimated time for completion -�
ALL WORK TO BE IN ACCORDANCE WITH.TUWN 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. Only holders of P-1, P-7" or W-9 licenses
will be issued a permit. PERMIT WILL EXPIRE THIRTY(30) DAYS AFTER
DATE DF-ISSUANCE. The undersigned Drain Layer hereby agrees to all the terms
and conditions set forth in the permit and attached thereto.. Applicant has recewed
Town Street Excavation Permit No. and/or ConnDOT Permit No.
} PLEASE NOTE:
= CBYD�No. ] S���,c� l S�. 1FA SANITARrSSWER.LATERAL
tSWITfffN75 FEET OFA WELL
,iTMUSTBEArR TESTED
Signed:
Print Name. �
'c Ucensed Drain Layer
Y� 1
Date:,
f standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMrr doc
it
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 7 �1
BUILDING ADDRESS dt
STREET : /ilz Z L gR PP4jD
SUBDIVISION:
NORTH ARROW
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CONTRACT R (PRINT) NAME OF CONTRAC R'S SUPERVISOR (PRINT)
STR,�ETEADDRESS SI TUBE
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TOWN STATE ZIP INSPECTED BY TOWN
3�0 2 � DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER