HomeMy WebLinkAboutDrain Layers Permits 50 Andrews Way (6) 1600021 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 05/16/2016
GIS ID: 03200050 FEE: 60.00
MUNIS APPLICATION# 201600607 - EXPIRATION DATE: 06/15/2016
APPLICANT /; LOCATION
NAME: BUTLER COMPANY ADDRESS: 50 ANDREWS WAY
ADDRESS: 848 MARSHALL PHELPS gOAD OWNER: OIJTH;WINDSOR DEVELOPERS LLC
WINDSOR, CT 06095 26 IvIAIl STREET SUITE 100A
CHATHAM,NJ 07928
PHONE 860-688.8024
WORK DESCRIPTION: LATERAL CONNECTION FOR BATHROOM POOL HOV'SE BY CLUB HOUSE
THE DRAIN LAYER ASSIGNED TO THIS PERMIT-HAS A VALID LICENSE ISSUED`BY;TH ""STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH IIVTHEATTACHED`CONDITIONS'.:ALL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHA REQUIREMENTS,AND TTIE ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
5/16/2016 8:47 AM
- - ------ -
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR:
LOCATION: ( c—o
TYPE OF WORK:'za v
DATE INSP NEEDED: DATE INSP: 5 l Le
INSPECTED BY: 6n
WORK IN
PROGRESS: j Py c .S biz
rreh$g / S.MI/ 0 ✓A&Z yet sf926
PcY2-t S'K�ro���e�
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT:
S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14 -
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR A
1540 SULLIVAN,AVENUE
PUBLIC WORIGS DEPARTMENT
TOWN HALL
SOUTH WINDSOR,Cr
TEE$60 00
-Location of proposed work: au5� Lpt#
Shed No. Name
'Premises owned �eex�
Name of Rtm: Phone. j9d 0 1---cP80��1�
Address of Firm: ��b"/ 1 s /���1 Vic,,
TYPE OF WORK:
Lay Houma Drat • Repair House Drain .
Lay Ma ln y Lateral fnr Commerdai/Industrial
Building of acres
Connection will be made with 35
Existing Water Supply: Public Water= Well
Proposed Start fts-t _ Estimated time for completion s
ALL WORK TO BE IN At,'OORDANCE WITH.TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA.WAREME TS AND CONDITIONS ATTACH®TO THE PERMIT
o � �� y
. Permit is bo be issued the holder of Drain
� uw�License No. Only holders of P-1, P-7. or W 9 licenses
will be issued a permit -PERMIT WILL EXPIRE THIRTY(30) DAYS AFTER
DATE OnSSUANCE. The undersigned Drain Layer hereby agrees to all the term
and conditions set forth in the permit and attached dmft.. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
• q�f� f ��f�� PLEASE NOTE:
f CBYD:No. TFA'SANITARYSEWER LATERAL
IS W WrN75FEkT OFA WELL
- . ; ITMI/ FAIR TESTED
Signed: Print Name: '' ohs
Drain Layer
Date:
SWrWaM nsVer�CAMN FOR DRA N LAYERS PERP .doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS 4094-Nd POOL
STREET
SUBDIVISION:
NORTH ARROW444-
I '
i -
- � -_- _
Ai
i i
, 1
i k t
CONTRACTOR (PRINT) NAME OF CONTRA TOR'S SUPERVISOR (PRINT)
M MgSH94n -PtWL?5 RAND
STREET ADDRESS SIGNATURE
wtwg sotz CT DATE
TOWN SATE Z P INSPECTED BY TOWN
QUO p Hl$ _ 9m—q DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER