HomeMy WebLinkAboutDrain Layers Permits 7 Lexie Lane (2) 1500081 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 11/17/2015
GIS ID: 53450007 FEE: 0.00
MUNIS APPLICATION# 201501693 EXPIRATION DATE: 12/17/2015
APPLICANT LOCATION
NAME: ATLANTIC EXCAVATION INC ADDRESS: 7 LEXIE LANE
ADDRESS: 363 PARUM ROAD OWNER: T&M BUILDING CO INC
COLCHESTER, CT 06415 110 BROOK STREET
TORRINGTON,CT 06790
PHONE
WORK DESCRIPTION: NEW SEWER CONNECTION BUILDING 17 SOUTH WINDSOR WOODS
PERMIT FEE COLLECTED UNDER APPL'201501.688
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 FORTFI IN THE ATTACHED`CONDITIONS'. ALL WORK 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 INS ECTED INSPECTED BY
1 1/17/201 5 4:02 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: I, � CONTRACTOR: E41� i>a 7'1611
LOCATION: l\l
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: /2 /ry
INSPECTED BY:
WORK IN -
PROGRESS: Co e brz'
Owe-► Lul ,e Tffi q SC'w col -e-cp iy DO o`+/
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED 0 YES ❑ NO
AS-BUILT:_
INPUT: ��' � DATE: ,
S/molloy/farms 2014 Town of South Wndw INPSECTt N REPORT 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVAU AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL
SOUTH WINDSOR,CT
FEE$60.00
Location of proposed work: Z�/,
Street No. Street Name
'Premises owned
Name of Firm: ��.�.�7�rc. ,cr,.��� // Phone: FCG„�,3%-// '
Address of
� c i�S
TYPE OF
. . WORK:
LaY House brain pair-
.House Drai •
R
Lay Main ; Lay Lateral for Commerdal/Industrial
Building of aces
Connection will be made with e_PC_ 5DX 3, 5 .
Bdsting Water Supply: Public Wafter �L- Wt41
Proposed Start Date Estimated time for completion Z,2,
ALL WORK TO BE IN ACOORDANCE WMi TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA.REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is W be issued to the holder of Drain
Layer's License No. o S - . Only holders of i�1, P-7. or W 9 licenses
Will be issued a permit. PERMIT WILL EXPIRE THIRTY(30) DAYS AFTER
BATE DFISSUANCE. The undersigned Drain gayer hereby agrees to all the terms
and conditions set forth in the permit and attached thereto.. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
PLEASE NOTE:
aYD No. a/.S" 7 3/ rFA SgNZTARYSBWEi R.LATERAL
IS WITf/IN75FE47OFA WELL
rTNVSTBEAIR TESTED
Sign Print Name: do� s o f/
Licensed Drain er
Date: '11�1/".7-
standard Fwnsw mltswPUanw FOR "qN LAYERS PERMIr-doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: ! /S
BUILDING ADDRESSlav
STREET
SUBDIVISION: ���
NORTH ARROW
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7 fi
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CONT CTOR (PRINT) NAME OF CONTRACTOR'S SUPERVIS (PRINT)
STREET ADDRESS SIGNATURE
TOWN STATE ZIP INSPECTED BY TOWN
'?C0 r �f 2- 0 DATE
TELEPHONE NUMBER .
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER