HomeMy WebLinkAboutDrain Layers Permits 50 Andrews Way (5) 1600039 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 06/23/2016
GIS ID: 03200050 FEE: 60.00
MUNIS APPLICATION# 201600850 EXPIRATION DATE: 07/23/2016
APPLICANT LOCATION
NAME: BUTLER COMPANY ADDRESS: 50 ANDREWS WAY
ADDRESS: 848 MARSHALL PHELPS ROAD OWNER: SOUTH WINDSOR DEVELOPERS LLC
WINDSOR, CT 06095 2-6MAIN STREET SUITE 100A
CHATHAM,NJ 07928
PHONE 860-688-8024
WORK DESCRIPTION: NEW SEWER CONNECTION COMMERICAL BUILDING 9 UNITS 901-908
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 DATV INSPECTED INSPECTED BY
6/23/2016 9:36 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.; 16DODv� CONTRACTOR: 1,271ele
LOCATION: -5-0 f1 Y►rl,►�Y�r-�S 1�? �s
TYPE OF WORK:44,2 Spwef CDno Aida ,
/
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: f3D
WORK IN
PROGRESS: Le Covtm&"Y�
A 4
SEPTIC TANK PUMPED, S ASHED, 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 SUL.LTVAN AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL
SOUTH WINDSOR,CT
FEE$60.00
Location of proposed work: 6b_ V # .'� ..
Street No. Street Na
'Premises owned
Name of Firm: � f Phone..,
Address of nern l Zes ,
'TYPE OF WORK.
Lay House Drain - Repair House Drain, •
: .
Lay Main • Lay Lateral for Comm
ercial/Industriat r
Building of acres
Connection will be made with 1N t7
EASting Water Supply. Public Water rz We!!
Proposed Start Date -2 Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH.TOWN OF SOUTH WINDSOR STANDARDS
ALL OSHA REQUIREMENTS 0NDTRONS AITACHED TO THE PERMIT
Permit is to be issued to { �� �. the !der of Drain
Layer's License No. O02 . Only holders of P- , -7. o' W-9 licenses
will be issued a permit. PERMIT WILL EXPIRE THIRTY( AYS 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. and/or ConnDOT Permit No.
PLEASE NOTE:
CBYD No. r17 SANITARYSlWER LATERAL
fS WITHIN75 FEE TOFA WELL
` rrmvsST , AIR TESTED
y Signed. Print Name: 7 0,6-�,r7- 1,�qe cz X3
c n ed Drain Layer
Date: /
Standard Forms\Permit wPucA-noN FOR DRAIN LAYERS PERMiT.doe
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 7 -6 ^ /4
N n is
BUILDING ADDRESS S'o AnAr,Pvjs way
STREET
SUBDIVISION:
NORTH ARROW
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70
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CONTRACTOR (PRINT) NAME OnNT09SU RVISOR (PRINT)
STREET ADDRESS SIGNATURE
a A DATE
TOWN STATE ZIP INSPECTED BY TOWN
0 U 'y1�2� DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER