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HomeMy WebLinkAboutDrain Layers Permits 131 Pepin Place (2) 1500065 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 11/04/2015 GIS ID: 70700131 FEE: 0.00 MUNIS APPLICATION# 201501589 EXPIRATION DATE: 12/04/2015 APPLICANT LOCATION NAME: ATLANTIC EXCAVATION INC ADDRESS: 131`PEPIN PLACE ADDRESS: 363 PARUM ROAD. OWNER: T&M BUILDING CO INC COLCHESTER,CT 96415 110 BROOK STREET TORRINGTON,CT 06790 PHONE WORK DESCRIPTION: NEW SEWER CONNECTION BLDG 18 PERMIT FEE COLLECTED ON APPL 201501587 THE DRAIN LAYER ASSIGNED TO THIS-TIER-MIT 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. C 711vt/��fj rr �li /ice ISSUED BY DATP INSPECTED INSPECTED BY 11/4/2015 2:37 PM TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT N04: oo© S-` CONTRACTOR: `fi�rxr2 i ���/ d1� LOCATION: TYPE OF DATE INSP NEEDED: DATE INSP: INSPECTED BY: p WORK IN PROGRESS: P vc sb �0 r s C f$ 7C3 iv1eL ® in/f(7:.t Yc.,jtJ �Lc. �4 COY+R� � t SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED Fl YES ❑NO AS-BUILT: INPUT: L,V� DATE: v S/molioy/forms 2014 Town of South Windsor M ECRON REPORT 14 APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR 1540 SUL UVAN•AYENUE PUBLIC WORKS DEPARTMENT TOWN HALL SOUTH WINDSOR,CT • �. �FEE$60.00 �. �q�e • : .vocation of proposed workss Street No. Street ame 'Premises owned Name of Firm: �V/,C,- c .-Q�� rs,'t Phone Address of Firm: C'3 �.«r� ���. /���T�. • �6'%�S TYPE OF WORK: / . . House Drai y it Drat • �Y n � � House R Lay Main—_____; Lay Lateral for Commerdai/Industrial Building of acres Connection will be made with 3Lr ` Existing Water Supply: Public Water_- Well Proposed Start Da Estimated time for completion ALL WORK TO BE IN ACCORDANCE WTfli.'TOWN OF SOUTH WINDSOR STANDARDS, ALL OSHA.REQUIREMENTS AND CONDMONS ATTACHED TO THE PERMIT Permit is to be issued to -A Z��aL r7aft a holder of Drain Layer's LJoense No.QAO"r v-- P7 . Only holders of P-1, P-7. or W-9 licenses will be issued a permL .PERMIT WILL EKPIRE THIRTY(30) DAYS AFTER DATE OF-ISSUANCE. The undersigned Drain Layer hereby agrees to all the.terms and conditions set forth in the permit and attached thereto.. Applicant has received Town Street 6ccavation Permit No. and/or ConnDOT Permit No. PLEASE NOTE: CBYD N0. o 6/S Y i'o lFA$ANITARYShWER•LATERAL IS WrrHrN 75 FEE r OF A WELL ZrNl1STBEArR TESTED Sign Print Name:�•`c l�`� l ,� ,c - Y Ucensed Drain Lr Date._. Standard Forms\Permit WPUCATION FOR M41N LAYERS PERMIT.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: //1/6' his BUILDING ADDRESS i 3/ J T e Vs STREET SUBDIVISION: NORTH ARROW � J CV so -1 ' r �► r i f , �- CONTRACTOR (PRINT) NAME OF CONTRACTOR'S.SUPERA R_ (PRINT) STREET ADDRESS SIGNAT E TOWN STATE ZIP INSPECTED BY TOWN C7- �S 37`d Ss�� DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER