HomeMy WebLinkAboutDrain Layers Permits 470 Foster Street (2) 1600045 TOWN OF SOUTH WINDSOR, CT
PENT NUMBER DRAIN LAYER PERMIT
DATE: 09/01/2016
GIS ID: 33300470 FEE: 60.00
MUNIS APPLICATION# 201601185 EXPIRATION DATE: 10/01/2016
APPLICANT LOCATION
NAME: EAGLE EARTHWORK SERV ADDRESS: 470 FOSTER ROAD
ADDRESS: 101 N MOUNTAIN ROAD , =-`OWNER: MANNARINO BUILDERS INC
CANTON, CT 06019 4QO.CHAPEL RD#3F
SOUTH WINDSOR,CT 06074
PHONE 860-603 2027
WORK DESCRIPTION: NEW SEWER CONNECTION
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 B DATE INSPECTED INSPECTED BY
9/1/2016 8:27 AM
- --- -- ------- -
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.; CONTRACTOR:
LOCATION: 7i)'
TYPE OF WORK: JI1'(")
DATE INSP NEEDED: DATE INSP: ti ,Z
INSPECTED BY: QD
WORK IN
PROGRESS: G
Pro
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: �' � DATE:
S/molloy/forms 2014 Town of South Windsor INPSEC RON REPORT 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SUU-IVMAVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL
SOUTH WINDSOR,CT
FEE$60.00
-Location of proposed Work: 12D Lot
Shed No. Street Name
'Premises owned by: evia")4 a
Name of Rnn: _ 4 zftone: a 617
Address of Firm: 16 � 1"l 4N ��a
TYPE OF WORK:
Lay House Drai • Repair House Drain
Lay Main-----; Lay Lateral for Commercial/Industrial
Building of acres
r
• Connection will be made with
Existing Wafter Supply: Public Water Weir
Proposed Start Da l` �- CEstimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
All OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to ed C OX. the holder of Drain
Layer's License No. JC
Only holders of P-1, P-7. or W 9 licenses
will be issued a permit P RMIT WILL EXPIRE 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 received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No. ���/ �s� �/� PLEASE NOTE:
} rFA SUVITARYShWER LArBM
IS WITHIN75FERT OFA WELL
ZrMUSTSEAIR TESTED
Signed: Print Name: �?�`c`5 �r 1c
Licensed Drain Layer
Date:
Standard FonrMXPerM tsWMCAT10N FUR DRAIN LAYERS PERmr r doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: � -
BUILDING ADDRESS
STREET S' V-D
SUBDIVISION:
NORTH ARROW
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CONTRA (PRINT) NAME OF C RACTOR'S SUP RVISOR (PRINT)
S ET ADDRESS IV
SIGNOURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
aC-) li ` � DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER