HomeMy WebLinkAboutDrain Layers Permits 27 Shepard Way (3) 1600049 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 09/09/2016
GIS ID: 82600027
MUNIS APPLICATION# 201601207 FEE: 60.00
EXPIRATION DATE: 10/09/2016
APPLICANT - LOCATION
NAME: T&M BUILDING CQ.,INC. ADDRESS: 2 ---SHEPARD WAY
ADDRESS: 110 BROOK STREET OWNER: T&M BUILDING CO INC
TORRINGTON,CT a6790 11.0".BROOK STREET
TORRINbTON,CT 06790
PHONE 860-883-5910
WORK DESCRIPTION: NEW SEWER CONNECTION FOR DUPLEX 25&27 SHEPARDS WAY
SOUTH WINDSOR WOODS-
THE DRAIN LAYER ASSIGNED TO THISTERMIT HAS A VALIb 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.
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ISSUED BY ,, DATE INSPECTED
INSPECT BY
9/9/201 6 1 1:53 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
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- -- --PERMIT NO: t -------CONTR-AC-T-ACLy' - - ----
LOCATION: ,S
TYPE OF WORK: c�� c;c� %( i��►
DATE INSP NEEDED: DATE INSP: it /e'
INSPECTED BY:
WORK IN .
PROGRESS:—_ Ale_- S4bram- s
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SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT: 1 DATE: �/ I
S/molloy/f rms 2014 Town of South Windsor INPSECTION REPORT 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: �� '� 007 dl Lot # 3,
Street No. ctreeet Name
Premises owned by:
Name of Firm: G„ , c 4fXc��,� �r� -.1�1c Phone:
Address of Firm: _s �r�m j ,ZZ,-lei C7 00 ylS
TYPE OF WORK:
Lay House Drain --'�; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of n�acres
Connection will be made with
Existing Water Supply: Public Water Well
Proposed Start Date lg Estimated time for completion l �y
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 »e?sue the holder of Drain
Layer's License No.cvow? 5l ^ ?7 . Only holders of P-1, 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 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. PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE AIR TESTED
Signed• Print Name:._ r 7�
Licensed Drain La
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESSL
STREET
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SUBDIVISION:
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CONTRACTOR (PRINT) NAME OF CONTRACTORS SUPER PRINT)
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STREET ADDRE SIGNATURE
00 DATE
TOWN p STATE per, ZIP INSPECTED BY TOWN
0 J1/�� DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER