HomeMy WebLinkAboutDrain Layers Permits 20 Clark Street (2) 1600056 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 10/05/2016
GIS ID: 20400030 FEE: 60.00
MUNIS APPLICATION# 201601455 EXPIRATION DATE: 11/04/2016
APPLICANT LOCATION
NAME: SIMSCROFT ECHO RARMS ADDRESS: 30 GLARK STREET
ADDRESS: P 0 BOX 581 OWNER: MANNARINO ROBERT&
SIMSBURY,CT 06070 " 406-CHAPEL ROAD#3F
= SOUTH WINDSOR, CT 06074
PHONE 860-65 f-A231
WORK DESCRIPTION: DEMOLISHING HOUSE
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 AT `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 NSPECTED INSPECTED BY
10/5/2016 2:23 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: f 6 600S"il CONTRACTOR: aa.S ✓�>' f
LOCATION: 3b 1 cn V_ tree
TYPE OF WORK: i r
A�
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS: w
SEPTIC TANK PUMPED, HED, FILLED WITNESSED ❑YES [INO
AS-BUILT:
INPUT: �'-� DATE:
S/moffoy/forms 2014 Town of South Windsor INPSWaON REPORT 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVAN-AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL.
SOUTH WINDSOR,CT
FEE$60.00
Location of proposed work: 3v Cam.
Street No. Street Name
'Premises owned by.-
Name of firm:J �,n
' Address of Firm: 1 l l d 9 -n L 42
TYPE OF WORK:
Lay House Drain Repair House Drain
Lay Main_-----; Lay Lateral for Commercial/Industrial
Building of ages
Connection will be made wfth
Existing Water Supply: Public Water_ Well
Proposed Start Date Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH.TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENT`S AND CONDI IONS ATTACHED TO THE PERMIT
Permit is to be issued f�0.n, ,; �� the holder of Drain
Layer's License No;LL-v,.a ' Qa 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.
PLEASE NOTE:
' } CBYD No. 70 i L L4 oo i 5 ► TFA SANITARYSkWER.LATERAL
IS WITHIN75FMT OFA WELL
.. � ,t�`MllSTBEALR TESTED
Signed:. Print Name.-
Licensed Drain Layer
Date: ��-
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Standard Forms\Permils\APPLIC:TION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: �� - 6 - 90, te
BUILDING ADDRESS 30
STREET
SUBDIVISION:
NORTH ARROW
770
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CONTRACTOR (PRINT) NAME OF CONT TORS SUPERVISOR (PRINT)
STREET ADDRESS SIGNATUR
TOWN STATE ZIP INSPECTED BY TOWN
96 6) - 40 6 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER