HomeMy WebLinkAboutDrain Layers Permits 164 Pepin Place (2) 1500088 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 11/18/2015
GIS ID: 70700164 FEE: 0.00
MUNIS APPLICATION# 201501704 EXPIRATION DATE: 12/18/2015
APPLICANT LOCATION
NAME: ATLANTIC EXCAVATION INC ADDRESS 164 PEPIN PLACE
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 SOUTH WINDSOR WOODS
PERMIT AMOUNT COLLECTED ON APPL 201501694
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 INSPE TED BY
11/18/2015 1:20 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT No : 2` ' CONTRACTOR: ,Y) %C
LOCATION: f ' / /I
a � .
'nrPE of Wo�c: �z r n�c 60j-�
DATE INSP NEEDED: DATE INSP:�� 1 q/`6-
INSPECTED BY: $�
WORK IN
PROGRESS: R)c st) e
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED El YES 0 NO
INPUT: DATE:
S/moi(oxibms 2014 Town of South Windoor DWSECrMN REPORT 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SUU IVAN-AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL
SOUTH WINDSOR,Cr
FEE$60.00
: -Location of proposed work: _ s . W
Strut No. Stred Name
Premises owned CS
Name of Rrm: -�1,► Phone: "cs
Address Of Firm:_, e c,� 2w-',, �'��c/ C .l 0 y/S'
TYPE OF WORK:
Lay House Drain `��• Repair House Drains ;
Lay Main : Lay Lateral for CommerdalAndust ial
Building.. of aces
Connection will be made with
Bftng Water Supply: Public Water �� Weil
Proposed Start D !lZI Estimated time forcompletion ,�,�•
ALL WORK TO BE IN ACCORDANCE WITH.TOWNOF SOUTH WINDSOR STANDARDS,
ALL OSHA.REQUIREMENT'S AND CONDTRONS ATTACH®TO THE PERMIT
Permit is to-be issued to the holder of Drain
., Layer's License No.cn,2nRMrL 1/ =27. Only holders of P-1, P-7. or W 9 licenses
will be issued a permit. PERMIT WILL EXPIRE THIRTY(3o) 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 Excavation Permit No. and/or ConnDOT Permit No.
PLEASE NOTE:
CBYD'No. (f5/,5 el,7C ZFA'S4NITARYS •LATERAL
IS Wn71ZN7SFERT OFA WELL
ITMUSTSEAIR TESTED
Sign Print Name:� 1., �c�
Licensed Drain *er
SWnda[d FbMtftMb\APPLiCAIION FOR DRAIN LAYERS MW.doc. :. .
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET
SUBDIVISION:
NORTH ARROW
-14
TE
fO I , '+ j �• Fill
I � I
i i i ► ; I `
We
10
I __t__.-
CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIG ATURE
TOWN STATE ZIP INSPECTED BY TOWN
57?2 -- O Y P d DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER