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HomeMy WebLinkAboutDrain Layers Permits 25 Lexie Lane (2) 1500078 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 11/17/2015 GIS ID: 53450025 FEE: 0.00 MUNIS APPLICATION# 201501690 EXPIRATION DATE: 12/17/2015 APPLICANT LOCATION NAME: ATLANTIC EXCAVATION INC ADDRESS: 25 LEXIE LANE ADDRESS: 363 PARUM ROAD OWNER: T&M BUILDING CO INC COLCHESTER, CT D6415 110 BROOK STREET TORRINGTON, CT 06790 PHONE WORK DESCRIPTION: NEW SEWED CONNECTION BUILDING 17 SOUTH WINDSOR WOODS PERMIT FEE COLLECTED WITH APPL 201501688 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. ISSUED BY DATE INSPECTED INSPECTED BY 11/17/2015 3:20 PM TOWN OF SOUTH WINDSOR INSPEC17ON REPORT A PERMIT NO..—L�- CONTRACTOR: G,'h LOCATION: 'TYPE OF WORK: �Lt,) DATE INSP NEEDED: DATE INSP: INSPECTED BY: fop WORK IN PROGRESS: reeil hw�&,lr� Ls,4/W Pv AO i V. SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED YES ❑ NO AS BUILT: INPUT: DATE: S/molioy/forms tom Town of South Windsor INPSwmN wottT m 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 Street No. Street Name Premises owned by: 1�? /,e►tcz 9. Name of Finn: , 'AZI�,-r, 7 Ic. c4 �/.Phone: Aridness of C%c:DC%/,S TYPE OF WORK- Lay House Draini • Lay Main —� Repair House Dra rL Lay Lateral fbr Commerdai/Induslrial Building of awes • Connection will be made with f�C �5'l�i' 3,5 . Existing Water Supply: Public Water= Well Proposed Start Date Estimated time for completion ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS, ALL OSHA.REQUIREMENTS AND CONDTRONS ATTACHED TO THE PERMIT Permit Is too be issued to ��.�C�_ the holder of Drain Layer's License No. ©SS Only holders of P-1, P-7. or W-9 licenses will be issued a perFnIL PERMIT WILL EKPIRE THIRTY(30) DAYS AFTER DATE-OF-ISSUANCE. The undersigned Drain Layer hereby agrees to all the germs ...and conditions set forth In the permit and attached thereto, Applicant has received Town Street Bmavation Permit No. and/or ConnDOT Permit NO. PLEASE NOTE: CBYD No. . 5- y7o 17, lFA SAN rrARYSAffR•LATERAL ISW WrN75FEETOFA WELL ZTNVSTEEArR TESTED Sin �z � �Zg a Print Name: Zoc, CS s y Licensed Drain er Date:_.__ 5• standard ftmAftmft\APPuCAnoN FOR oRAIN LAYERS PERmrr doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: ! s" BUILDING ADDRESS 17 l0s =1 e STREET : SUBDIVISION: u .� NORTH ARROW q?y�, i fr - t 17 CONT ACTOR (PRINT) NAME OF CONTRACTORS SUPERV1S (PRINT) 3 L:�D - - STREET ADDRESS SIGNATURE Oy c 9<57 TOWN STATE ZIP INSPECTED BY TOWN 0 DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER