HomeMy WebLinkAboutDrain Layers Permits 399 Foster Street (5) 1600022 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 05/16/2016
GIS ID:33600399 FEE: 60.00
MUNIS APPLICATION# 201600608 EXPIRATION DATE: 06/15/2016
APPLICANT LOCATION
NAME: D SPIELMAN ENTERPRISES LLC ADDRESS: 399"FOSTER STREET
ADDRESS: 50 WINDEMERE AVE OWNER: _ , ENDRE-MIKE
ELLINGTON,CT 06029, 57 LOVELAND HILL RD
VERNON,CT 06066
PHONE ;
WORK DESCRIPTION: RECONNECTIOlxt TO SEWER
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 TH1 ATTACHED`CONDITIONS'. ALL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHA REQUIREMENTS,AND THE ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
5/16/2016 10:21 AM
4
TOWN OF SOEJTH WINDSOR INSPECTION REPORT
PERMIT NO:: CONTRACTOR:
LOCATION: �9 �5 � S
TYPE OF WORK: ��
DATE INSP NEEDED: DATE INSP: /
INSPECTED BY:
WORK IN
PROGRESS: C •��.a�� ;:�r /�Gs� (� ' pv� 52 3S y�a�..
a.ct c!- �� ��.� b.�✓ids b�zj r. Lzr�iLC'Ti'�� '� y�r Sc_r'1 �p
SEPTIC TANK PUMPED, ASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT: DATE:
5/molioy/forms 2014 Town of South Windsor INPSEMON REPORT 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVAN AVENUE
PUBLIC WORIGS DEPARTMENT
TOWN HALL
SOUTH WINDSOR,CT
FEE$60.00
Location of proposed w oric `� �4 Lr t#
Suet No. Street Name
Premises owned by: M ��� fi
Name of Arm: '' +of Phone: -57 �/y�
Address of FI m: �'C5 z 1�i
TYPE OF WORK:
- . . Lay House Drain✓ ; Repair House Drain-
Lay Main_; Lay Lateral for Commercial/Industrial
Building_ of_awes
• Connection will be made with
Existing Water Supply. Public Water Well
Proposed Start Da �) Estimated time for completion
ALL WORK TO BE IN AOQ MMCE WM TOWN OF SOUTH WINDSOR STANDARDS,
ALL.OSHA.REQUIREMENTS AND CONDPRONS ATTACHED TO THE PERMIT
Permit is to be issued to K 1 v rz the holder of Draft
Layer's License No. 2 0 �"1 �� Only holders P-7. or W-9 licenses
will be Issued a permit. PERMIT WILL EKPiRE THIRTY(36) DAYS AFTER
DATE OFISSUANCE. The undersigned Drain layer hereby agrees to all the terms
...and conditions set forth In the permit and attached rft.. Applicant has received
Town Sb�eet EKcavatton permit No. _1\-nrt N) rZrk�ai W/or ConnDOT Permit No.
PLEASE NOTE:
CBYD No. 1FA SAIINITAR•YShWER-LATERAL
IS W WrN75 FEET OFA WELL
1TMVST5EAIR TiESTED
Sign Print 4Name��c
Ucensed Drain Layer
Date: .— )
7
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: -pil & _ �/f�
BUILDING ADDRESS '
STREET or
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CON CTOR'S SUP V (PRINT)
Ave " 411
STREET ADDRESS SIGNATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
9 ?96 DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER