HomeMy WebLinkAboutDrain Layers Permits 446 Pleasant Valley (2) 1500051 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 09/10/2015
GIS ID: 72900446 Nk FEE: 60.00
MUNIS APPLICATION# 201501230 EXPIRATION DATE: 10/10/2015
APPLICANT - LOCATION
NAME: JAMES THROWE DNA- ADDRESS: 44- -PL ASANT VALLEY ROAD
ADDRESS: 97 RIVERSIDE DRIVE OWNEi WOO*RIGHT HOMES LLC
VERNON ROCKVILLE,CT 0606- 845-MAIN ST
SOUTH INDSOR,CT 06074
PHONE 860-289 00 .5
WORK DESCRIPTION: NEW SAWRR CONNECT--0N`
THE DRAIN LAYER ASSIGNED TO THISPERMIT HAS A,VILID LICENSE ISSUED BY TI31y 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.
�.
2)
ISSUED BY J DATE INSPECTED INSPECTED BY
9/10/2015 9:20 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:; I<. QQy, CONTRACTOR:
LOCATION: y Gj
IJ
TYPE OF WORK: 1 k W �,v�
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: 6L
WORK IN
PROGRESS: L' o� .-A �f�.- �''ti� Svc 3 4-
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: ell, DATE: l
S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR -
1540 SULLIVAN AVENUE
PUBLIC WORKS DEPARTMENT
� _ --
SOM DSOR,,_CT
FEE$60.00
: .Location of proposed work: 4q�, t`;(/ k Lot#
Shed No. Shied Name
P.remLses owned
Name of Arm:
•
Address of Finn: �►.� �•1,,�f I/c�, :�.
TYPE OF WORK:
fray House Draln-X Repair House Drain ;
Lay Main � Lay Lateral for CommerdaVIndustrial
Building of acres
• Connection will be made with
6dsting Water Supply: Public Wager= Well
Proposed Start Da 9/_
Estimated time fir Nmpietian I /
ALL WORK To BE IN Ac=DANCE WITH.TOWN�OF SOUTH WINDSOR STANDARDS,
ALL OSHA.BENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to j-7� the holder of Drain
Layer's License No. F f=, Only holders of P-1, P-7. or W-9 licenses
will be issued a permit: -PERMIT(KILL EXPIRE THIRTY(30) DAYS AFTER
DATE GFISSUANCE. The undersigned Drain Layer hereby agrees to all the terns
and eondltions set forth in the permit and attached thereto.. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
PLEASE NOTE:
( YD 1FA mNrrARrSkwR-LATERAL
ISWITHIN75FE4TOFA WELL
ITMUSTBEAIR D
Signed: Print Name:_ -5 710
Licensed Drain Layer
Date: All
Standard Foams\ WAM ICA71ON FOR DRAIN LAYERS PERM.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: � IS
BUILDING ADDRESS 9</49
STREET : pj Sri l
T I
SUBDIVISION:
NORTH ARROW
I EAge
01
dl
1 � {
( _
z
—77
t
l y i 1
L I i
CONTRACTOR (PRINT) NAME OF CONT TOR'S SUPERVISOR (PRINT)
ky
STREET ADDRESS SICPATURE �^►
DATF
TOWN STATE ZIP INSPECTED BY TOWN
760 c j crj - - DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER