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HomeMy WebLinkAboutDrain Layers Permits 9999 Nevers Road (2) 1500044 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 07/20/2015 GIS ID: 62409999 FEE: 0.00 MUNIS APPLICATION# 201500947 EXPIRATION DATE: 08/19/2015 APPLICANT ,- LOCATION NAME: HINCKLEY CONSTRUCTION INC -DDRE§-S NEVER-S ROAD ADDRESS: 178 HIGHLAND VIEW DRIVE= OWNER TOWNF SOUTH WINDSOR SOMERS, CT 06071 - 1540 SiLLIVAN AVE SOLITH-�VINDSOR,CT 06074 PHONE WORK DESCRIPTION: NEVER§X-- b 0 ONSTRUCTI N PRCiTECT ISJO FEE THE DRAIN LAYER ASSIGNED TO THIS PEIVH IIT A V S A ALID LII NSE ISSUI I3`BY TH) STATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FORTH IN TH1 ATTACHED`CONDTTI01�1S'. ALL 13fORK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDAR]?S,ALL OSHA REQUIREMENTS,AND TkIB ATTACHED CONDITIONS. ISSUED BY DATE INSPECTED INSPECTED BY 9/15/2015 10:09 AM TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO:; 5_ 00� CONTRACTOR: LOCATION: G OPr _ (� TYPE OF WORK: DATE INSP NEEDED: DATE INSP: Z 5 INSPECTED BY: t3 b WORK IN PROGRESS: iO C i ys'i teaj Yt/1'S ,o )Ai;og-1 cX4c4c\.ed &d'44 '4 S-" se.,,e-t /F1c+iY1 f r .3 Cc"I"� (.4Pv M ' Su v j lt_e- 90 SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: . lam - DATE: (C� S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14 APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR 1540 SULLIKAUAVQWE PUBLIC WORKS DEPARTMENT SOL iWINDSOR,CT- FEE$60.00 Location of proposed work: 9 )�'y�P►/ C� Lot# Street No. Street Name 'Premises owned by: Name of firm t/ & phone: Address of firm: /a12 .e TYPE OF WORK: Lay House Drat��. Repair House Drain • Mai ✓ • _ Lay n Lay Latent for Cornmerrlai/Industrial Bulldlna of aa-es Connection will be made with Existing Water Supply: Public Water._,_ Well Proposed Start Date ^Estimated time for Completion ALL WORK TO BE IN ACOORDANCE WIfH.TOWN OF SOUTH WINDSOR STANDARDS, ALL OSHA REQUIREMENTS AND CONDTIIONS ATTACHED TO THE PERMIT Permit is to be issued to the holder of Drain Layer's License No. Only holders of 1-1, P 7. or W-9 licenses will be issued a permlt PERMIT WILL EXPIRE THIRTY(30) 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. aril/or ConnDOT Permit No. PLEASE NOTE: r` CBYD*No. lFA-SANITARY&WER LATERAL IS WITMIN75FE4TOFA WELL ZTML6TBEAtR TESTS© Signed: Print Name: Licensed Drain Layer Date: Standard Fans\Permit vUPP ICA'n0N FOR WJUN LAYERS PERMU.doc