Loading...
HomeMy WebLinkAboutDrain Layers Permits 50 Crestwood Drive (2) 1600027 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 06/09/2016 GIS ID: 24600050 FEE: 60.00 MUNIS APPLICATION# 201600764 EXPIRATION DATE: 07/09/2016 APPLICANT LOCATION NAME: JAMES THROWE DNA _ .ADDRESS:' 50 CRI3STWOOD DRIVE ADDRESS: 97 RIVERSIDE DRI57E ©WNER: WILLIAMS JONATHAN&SARAH H VERNON ROCKVILLEW CT 06066 50 CRESTWOOD DRIVE SOUTH=WINDSOR,CT 06074 PHONE 860 2891 U095 i WORK DESCRIPTION: NEW SIWI R CC1I*IATCTTON THE DRAIN LAYER ASSIGNED TO THIS PEI MITH2 A VAi ID LIC ENSE ISSUED BY"THE STATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FORTH IN THEATTACHED`CONDITIONS', kI L WORK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHA'REQUIREMENTS,AND THE ATTACHED CONDITIONS. c D C f -� ISSUED B DATE INSPECTED INSPECTED BY 6/9/2016 8:53 AM - - - TOWN OF SOUTH WINDSOR INSPECTION REPORT �7 PERMIT NO:; CONTRACTOR: tAy1 LOCATION: Or I 4 TYPE OF WORK: lL)ecA) . f't)�a� n� DATE INSP NEEDED: DATE INSP: e l/4 INSPECTED BY: WORK IN PROGRESS:_ Ca ?S Fro—, SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED YES ❑ NO AS-BUILT: INPUT: DATE: S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14 APPLICATION 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: Cre�S-f ut�� Lot# Street No. Street Name 'Premises owned by: 0 Name of Rrm Phone;cN3 Address of Firm: TYPE OF WORK: Lay House Drain Repair House Drain Lay Main_; Lay Lateral for Commerdai/Industrial Building of acres Connection will'be made with A5 Bdsting Water Supply: Public Water= Well Proposed Start Date 2Q Estimated time for completion91JUIJ ALL WORK TO BE IN ACCORDANCE WTTH.Tovm OF SOUTH WINDSOR STANDARDS, ALL OSHA_REQUIREMENTS AND CONDTIIONS ATTACHED TO THE PERMIT Permit IS to be issued to Ja � the holder of Drain Layer's License Na , 3 Only holders of Ri, P-7. or W-9 licenses will be issued a permit. PERMIT WILL EXPIRE THIRTY(30) DAYS AFTER DATE OF ISSUANCE. The undersigned Drain Layer hereby ages to all the terms and conditions set forth In the permit and attached themto.. Applicant has received Town Street Excavation Permit No. and/or ConnDOT Permit No. PLEASE NOTE: CBYD N0.aZ1O Z Ss'Z� . IFA SANITARYSEWER-LATERAL IS WITHIN75FEET OFA WELL I7'M11S7'BEArR TESTED Signed: 1 Print Name: JXft,GS � 1. Licensed Drain Layer Date:Z J v rJ l� Sta►#aW Forms\Per bXAPPLICATION FOR DRAIN LAYERS PERMrr.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS J o STREET : 42 resla)60 c� SUBDIVISION: NORTH ARROW : -- --- - - �- : I I k-- - p `i , I Uc ! j ---�-�� CONTRACTOR (PRINT) NAME F CONTRACTOR'S UPERVISOR (PRINT) 7) Rw-Ilk A- STRE ADDRESS SI URE v ���� r �� C/� DATE TOWN STATE ZIP INSPECTED BY TOWN 'W o a 7d�1 o0a DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER