HomeMy WebLinkAboutDrain Layers Permits 454 Oakland Road (2) 1500061 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 10/28/2015
GIS ID: 65700454 FEE: 60.00
MUNIS APPLICATION# 201501386 EXPIRATION DATE: 11/27/2015
APPLICANT LOCATION
NAME: JAMES THROWE DEW ADDRESS 454`OAKLAND ROAD
ADDRESS: 97 RIVERSIDE DRIVE OWNER: DOLLAK GARY
VERNON ROCKVIL,LE,,CT 06066 454- OAKLAND ROAD
- S%3H VINDSOR, CT 06074
PHONE 860-289 0095 -
WORK DESCRIPTION: NEW SEWRR CONNECTION
THE DRAIN LAYER ASSIGNED TO THISPEIWIT HAS A VALID LICENSE ISSUED BY THE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FOR'1'H4IN THE ATTACHED`CONDITIONS'. ALL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHA RE¢UIREMENTS,AND THE ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
10/28/2015 10:09 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:; ,��® CONTRACTOR: J
LOCATION: �(`� o 4 i-
TYPE OF WORK: Le
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DATE INSP NEEDED: DATE INSP: t I
INSPECTED BY: (3
WORK IN
PROGRESS: re1c-
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SEPTIC TANK PUMPED, SMASHED, FILLED ` WITNESSED YES EJINO
AS-BUILT:
INPUT: DATE: _
S/molloy/forms 2014 Town of South Windsor INPSECTION REPORT 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVANAVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL
SOUTH WINDSOR,CT
FEE$60.00
Location of proposal work: ._�/S'y c��k`Gn
sued NO.
(� Sbvet Name
Premises owned by:
Name of Firm.-4 d (c' ^v► _Phone:��D SS
Address of CL
TYPE OF WORK:
Lay House Drainer Repair House Drain
Lay Main_; Lay Lateral fbr Commercial/Industrial
Building of_acres
Connection will be made with_Sne 5' �g�
Existing Water Supply: Public Water_ Wd
Proposed Start Dab Estimated_ matxd time far completion h
ALL WORK i�E IN ACCORDANCE WrM.70WN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENT5�J4ND )ONDTPIONS ATTACH®TO THE PERMIT
Permit Ls to be issued to_ r a the holder of Drain
Layer's License No. _ �3 Only,holders of i-1,P-7. or W-9 licenses
will be issued a permit. PERMIT WILL EXPIRE THIRTY(30) DAYS AFTER
DATE aF ISSUANCE. The undersigned Drain Layer hereby agrees to all the terms
and conditions set forth In the permit and attached thwetD.. Applicant has received
Town Sheet Excavatlon Permit No. and/or ConnDOT Permit No.
PLEASE NOTE:
F CBYD'No. TPA-s.4NlTARYsawR.L4TERAL
M MMM75fE470FA WELL
1TMUSTBEAr TESTED
Signed: LPrint Name:_ -T PC
s
Licensed Drain Layer
41 liuAaA,
Date:3-7 CXT l
Surd FMB\PeMitSWMCATION FOR MM LAYERS PIt W doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: IC //s
BUILDING ADDRESS ���
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STREET . O ckk jr_��
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTO 'S UPERVISOR (PRINT)
STREET ADDRESS SIG TURE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE — TOWN PINK = CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER