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HomeMy WebLinkAboutDrain Layers Permits 214 Long Hill Road (2) 1500057 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 10/14/2015 GIS ID: 54600214 FEE: 60.00 MUNIS APPLICATION# 201501448 EXPIRATION DATE: 11/13/2015 APPLICANT LOCATION NAME: SMITH MECHANICAL-LLC ADDRESS: 214 LONG HILL ROAD ADDRESS: 195 UNION STREET OWNER: MARTINO PETER&JUDITH MANCHESTER,CT 06042 214 LONG HILL ROAD SOUTH.WINDSOR, CT 06074 PHONE 860-646 3973 WORK DESCRIPTION: NEW SEWi CONNE.CTIdN" 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-- 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 10/14/2015 11:08 AM DATE INS ECTED INSPECTED BY TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO:: e�7 CONTRACTOR: LOCATION: 21 y I ©2n Q d i l> ? 2 d TYPE OF WORK: ���- f C o h/►��d�o . DATE INSP NEEDED: DATE INSP: INSPECTED BY: nt) WORK IN PROGRESS: eye cb r s 4-:-eel }b SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: ("A0, DATE: 4JAI S/molloy/forms 2014 Town of South Windsor INPSEC PION REPORT 14 APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR 1540 SUL UVAUAVENUE PUBLIC WORKS DEPARTMENT TOWN HALL SOUTH WINDSOR,CT FEE$60.00 : .Location of proposed work: / ��C G Lpt#_..._ Street No. Name Premises owned : /�� 1 y 0 �Y Name of Firm. Snfi� (�1 Icy LCC phone; 60AWZI7D Add.of Firm: 175 U,-v t chit/ 1� Il`�1 -�Gfi 7�r1 Cx1 060W TYPE OF - . . . WORK: Lay HouseIyf ..- Repair Home Drain ayMain L_:• ; Lay Lateral for Commerdai/Indusbial - Building of acres Connection will be made with � �)i/C Bftng Water Supply: Public Water Well r� Proposed Start Estimated time for oompletion /D ALL WORK TO BE IN ACCORDANCE Wllli.TOWN OF SOUTH WINDSOR STANDARDS, ALL OSHA.REQUIREMENTS AND CONDTRONS ATTACHED TO THE PERMIT Permit IS to be issued to -5",P e S5; 4 the holder of Drain Layer's Umnse No. A Q ,Q+ Only holders of P-11 P-7. or W-9 lkerm will be issued a permit. PERNff WILL EXPIRE THIRTY(30) DAYS AFTER DATE OF-ISSUANCE. The u II the germs undersig ned Drain Layer h agrees to a �Y 9 and condition s set forth in the if and ached theetD Applicant has receiv Town Street Excavation Permit No. and/or ConnDOT Permit No. PLEASE NOTE: r (:l3YD No. O 1FA,SANITARYSE`WER-LAram IS m71rN75FE4-TOFA WELL rTNUSTBEAIR TESTED Si ned: 9 -Print Name: t t+L U sed Drain Layer Date: Swnom.d Fom sftmit \APPICk17 Nv FOR DRAIN LAYERS PERMIT.&C TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS STREET : Lon# )14►// SUBDIVISION: NORTH ARROW I I 1 i c , , I I 1 I : i 1 I I i ! : _ 1 I i ' 1 CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT. STREET ADDRESS SIGNATURE �, DATE TOWN STATE ZIP INSPECTED BY TOWN l��' :1 �a cj ,r1 " D DATE TELEPHONE NUMBER WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER