HomeMy WebLinkAboutDrain Layers Permit 50 bldg 2 Andrews Wa (2) 1600002 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 01/06/2016
GIS ID: 03200050 FEE: 60.00
MUNIS APPLICATION# 201600016 EXPIRATION DATE: 02/05/2016
APPLICANT LOCATION
NAME: BUTLER COMPANY, ADDRESS: 50 ANDREWS WAY
ADDRESS: 848 MARSHALL PHELPS ROAD OWNER: SOUTH WINDSOR DEVELOPERS LLC
WINDSOR, CT 060g5 26 MAIM STREET SUITE 100A
CHATHAM,NJ 07928
PHONE 860-68&=8024
WORK DESCRIPTION: SEWEWCONNECTION FOR BUILDING 2 UNITS 201-224
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.
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ISSUED BY DA E INSPECTED INSPECTED BY
1/6/2016 12:16 PM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO-4 CONTRACTOR:
LOCATION: o2 lJ'
TYPE OF WORK: kftj) e(,UV C C® 0 V\z4 C-�6 V
DATE INSP NEEDED: DATE INSP: I I)4 G
INSPECTED BY: aJ
WORK IN
PROGRESS: 11 ( Pic. Szr2 � s ,�;�, 5r�'►1�
✓'012S Ll /77 4 4:/�-� J✓�.r r u h.✓�. � i� 3144 C►rin.�'�S=
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: (,` � DATE:
S/molloy/forms 2014 Town of South Windsor INPSECiION REPORT 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULUVAUAVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL.
SOUTH WINDSOR,CT
FEE$60.00
: .Location of proposed work: D/- k/ Lot#j to
Street No. Sbvet Name If
ftftses owned by:
Name of Rrm: - Phone:
Address of Rrm• f /Z/W dV.,_4v, :at G�
TYPE OF WORK:
-: . . Lay House Drain_ Repair House Drain
Lay Main : Lay Lateral for tAmmerdal/Industdal
Building of aaes
• Connettfon will be made with
Ewing Water-SupPdY' Public Water v Wdi
Proposed Start Dat g.; /" Estimated time for oampdetton
ALL WORK TO BE IN ACCORDANCE WITH.TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA.REQUIREMENTS PNDI717ONS ATTACHED TO THE PERMIT
Permit Is to be do the holder of Drain
Layer's Ucense No.XV b ?- . ty holders of P-1, P-7. or W-9 licenses
wdil be issued a permit PERMIT WILL EXPIRE THIRTY(30) DAYS AFTER
DATE OF ISSUANCE. The undersigned Drain Layer hereby agrees to all the temps
and conditions set forth in the permit and attached ffat .. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
PLEASE NOTE:
t0ACBY. D No. lFA'SANZ ARYSAVER-LATERAL
IS m7frN75FEETOPA WELL
.t"TINI/ FAIR TESTED
- Signed:. Print Name:
sed Drain Layer
Date: G
SWWW.d F PenmMU)PLICATION FOR QRJM LAYERS PERMII.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS er 2—
STREET
SUBDIVISION: r
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF ONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS IGNATURE
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TOWN STATE ZIP INSPECTED BY TOWN
�gr--�;6 Z I DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER