HomeMy WebLinkAboutDrain Layers Permits 6 Shepard Way (2) 1500069 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 11/04/2015
GIS ID: 82600006 FEE: 60.00
MUNIS APPLICATION# 201501593 EXPIRATION DATE: 12/04/2015
APPLICANT LOCATION
NAME: ATLANTIC EXCAVATION INC ADDRESS: 6 SHE PARD WAY
ADDRESS: 363 PARUM ROAD - - OWNER: T&M BUILDING CO INC
COLCHESTER, CT 06415 110 BROOK STREET
TORRINGTON,CT 06790
PHONE
WORK DESCRIPTION: SEWER COIrINECTION FOR SHEPARD WAY AND PEPIN PLACE BLDG 2
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 TN 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
11/4/2015 3:11 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: / r o D 4J CONTRACTOR: Afi/a h:Y-; _ (xc a-,/arm-id/'l
LOCATION:
TYPE OF WORK'—,J r Co nne :tiDn . !�� cS�/�ef�� a;,o
DATE INSP NEEDED: DATE INSP: 11 4,1,
INSPECTED BY: �b
WORK IN
PROGRESS:_ Co ej
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SEPTIC TANK PUMPED,SMASHED, FILLED wiTNESSED Fl YES ❑NO
AS-BUILT:
INPUT: ` DATE:
S/mdby/foms 2014 Taws of Sao imn&w MPSECM REPORT 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVAN-AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL
SOUTH WINDSOR,CT
FEE
Location of proposed work: r SC 'tvt-#
Streit No. Street Name
'Premises owned by: 7 / 7
Name of Firm: Phone:
Address of Firm: �—
TYPE OF WORK: J
Lay House Drain�Repair House Drain--------,
Lay Main ; Lay tafieral for Commerdai/Industriai
Building of acres
Connection will be made with S 35 .
Existing Water Supply: Public Water Well
Proposed Start Date .2� Estimated time for completion Z_rLi�cS
ALL WORK TO BE IN ACCORDANCE WMi.TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA.REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT'
Permit is to be issued to c • T ifie holder of Drain
Layer's License NO.0.29 gry 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-ISSUANCE. The undersigned Drain Layer hereby agnate to all the terms
and conditions set forth In the permit and attached thereto.. Applicant has receW
Town Street Excavation Permit No. and/or ConnDOT Permit No.
t o//S PLEASE NOTE:
CD No. _ rARY S5W •LATERAL� Nl
ISWITMrN75FEET0PA WELL
rrM16T8EATR TiESTEi D
Sign Print Nam 1--C e: �.�� %. � oc y
�Ucensed Drain Lay
Date:
SWWaW F=MXft mitSWWCAT10N FOR wAIN LAYERS PERmrr doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS �
STREET
SUBDIVISION:
NORTH ARROW
low
47
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPE :(PRINT)
_.7 j
STREET ADDRESS SIGNATURE
TOWN STATE ZIP INSPECTED BY TOWN
wo �S'`3,- y DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER