HomeMy WebLinkAboutDrain Layers Permits 50bldg 3 Andrews Wa 1600003
PERMIT NUMBER TOWN OF SOUTH WINDSOR, CT
DATE: 01/06/2016 DRAIN LAYER PERMIT
GIS ID: 03200050
MUNIS APPLICATION# 201600017 FEE;
EXPIRATION DATE: 60.
00
APPLICANT o2/os/2o 16
NAME: BUTLER COMPANY LOCATION
ADDRESS: 848 MARSHALL PHELPS'ROAD ADDRESS: 50 ANDREWS WAY
WINDSOR, CT 0609s OWNER; SOUTH:WINDSOR DEVELOPERS LLC
26 MAIN STREET SUITE 1 OOA
PHONE 860-60-8024 CHATHAM,NJ 07928
WORK DESCRIPTION: NEW SEWER CONNECTION BUILDING 3 UNITS 301-322
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 I-7
1/6/2016 12:40 PM DATE INSPECTED
INSPECTED BY
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:; 16 0000 3 CONTRACTOR:
LOCATION:___ S o A ndrew s Wd a 6)cla, -3 oki d s- ��-
TYPE OF WORK: 42r u-) ,S c.u,;e r (f)r?n)6�r v,
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: �D
WORK IN
PROGRESS: irc rz 3.3 f,��► sue►
TQ �;..��c�t qq�°' +�lvt+75 :3 c
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: - DATE:
S/moiloy/forms 2014 Town of South Windsor INPSEMON REPORT 14
APPL 0310N FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVAN-AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HAIL
SOUTH WINDSOR,CT
FEE$60.00
: .Location of Proposed Work:
Shied No. Sheet Name
PremLses owned by: - Z-6x
Name of Arm: -L4_7 pine.
Address of Firm:
TYPE OF WORK:
. - Lay House Drain_._.�___; Repair House Drain. .
Lay Main : Lay Lateral for Commerdai/Industriai
Building of aces
Connection will be made with Ale
d3dsfatng Water Supply: Public Water_ Well
Proposed Start Date Ste_Estimated Ome for oompleOon
ALL WORK 7O BE IN ACCORDANCE W177i.TOwN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS CONDTIIONS A7TACHED TO THE PERMIT
Permit IS W be Issued to the holder of Drain
Layer's License No. holders of P-1, P-7. or W-99 licenses
will be tss<ted a ppxrnit. PERMIT WILL EVIRE 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 neeW
-Town Sheet BwavaUbn Permit No. and/or ConnDOT Permit No.
PLEASE NOTE:
CBYD-No. ZFA'SffZrARYSOWER LATERAL
IS WIT1fIN75FERTOFA WELL
.d-rMV., EAIR TESTED
Signed: Print Name: '7Ae�
nsed Drain Layer
Dane: 71.h&-
ftmft\WUCA'n0N rya MM LAYM MWft
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS :
STREET : 15 c� 14kt�,e L _
SUBDIVISION: ✓
NORTH ARROW
1
illf
I
- - if -� --
i
1 1
CONTRACTOR (PRINT) NAME 0 CO TRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
C,Y(7 DATE
TOWN STATE ZIP INSPECTED BY TOWN
A'y y,l r J?L Z �/ DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER