HomeMy WebLinkAboutDrain Layers Permits 127 Pepin Place (2) 1500064 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 11/04/2015
GIS ID: 70700127 FEE: 0.00
MUNIS APPLICATION# 201501588 EXPIRATION DATE: 12/04/2015
APPLICANT LOCATION
NAME: ATLANTIC EXCAVATION INC ADDRESS: 127 PEPIN PLACE
ADDRESS: 363 PARUM ROAD = OWNER: T&M BUILDING CO INC
COLCHESTER, CT-6415 1 10 BROOK STREET
TOR,RINGTON,CT 06790
PHONE
WORK DESCRIPTION: SEWER CONNECTION BLDG 18
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
1 1/4/201 5 2:32 PM
TOWN OF SOUTH WINDSOR INSPECT30N REPORT
CONTRACTOR:
PERMIT NO:: � .Vd� %l� cr f '� jj
LOCATION: 1 a 7i f'1
TYPE OF WORK: `'� .l l
DATE INSP NEEDED: •
DATE INSP. it I 4e
INSPECTED BY: b
WORK IN
PROGRESS:-- yt sty �� ' PVC 5 o n
i,its 5 4 re-, i /4R G►r S
• 'i CPC
SEPTIC TANK PUMPED,SMASHCD, FIRED WITNESSED [l YES ❑NO
AS-BUILT:
INPUT: DATE:
S/moiloygorms 2014 Town of&no Windsor INP wmN REPORT m
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVAUAVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL
SOUTH WINDSOR,CT
;Pee Y FEE$60c00
: .L.ocaft of proposed work.^ 7 f, e # 4�0 /,r
Street No. Sb�eet ame
Premises owned by:_- `��/�! �� �S
r-- Phone: Y�
Name of inn: -��_ c .-Qi�s
Address of Firm:-JC
TYPE OF WORK:
Lay House Drain 41 ; Repair House Drain.
Lay Main_; Lay Lateral for Commerrlai/Industrial
Building of_awes
Connection will be made with�' t7 31 R
Existing Water Supply. Public Water r Wdl
Proposal Start Daft G*Estimated time for completion — c�
ALL WORK TO BE IN ACOORDANCE WITH.TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA.REQUIREMENTS AND CONDnIONS ATTACHED TO THE PERMIT
Permit is to be issued to �
, � tfie holder of Drain
Layer's License No.CV—d Crr v-. P7 •. Only holders of P-1,P-7. or W-9 licenses
will be issued a permit. -PERMIT WILL EXPIRE THIRTY(30) DAYS AFTER
DATE OF The undersigned Drain Layer hereby agrees to all the terms
and conditions set forth in the permit and attached them.. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
PLEASE NOTE:
' CBYD No. c/S lPA'S�INITARYS�WER G4TERAL
IS 9#7 THIN75PE4-T OF WELL
ITNIISTBEAIR TESTED
Sign Print Naine: s • ,1
Licensed Drain Lr Y
Date:_._, i.,,Ale
SWnldard ForAPermit XAPPLICATION FOR DRAW LAYERS PERW doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS : '/a 7 J31 75
STREET
SUBDIVISION:
NORTH ARROW
41
y
-' i
CONTRACTOR (PRINT) NAME OF I CONTRACTOR'S S UPERVI R (PRINT)
STREET ADDRESS SIGNA E
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TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER