HomeMy WebLinkAboutDrain Layers Permits 83 Chaponis Way (2) 1600081 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 11/23/2016
GIS ID: 18270083 FEE: 60.00
MUNIS APPLICATION# 201601751 EXPIRATION DATE: 12/23/2016
APPLICANT LOCATION
NAME: EAGLE EARTHWORK SERA ADDRESS: 83 CHAPONIS WAY
ADDRESS: 101 N MOUNTAIN ROAD OWNER: MANNARINO BUILDERS LLC
CANTON, CT 060100HAPEL ROAD#3F
SOU I H WINDSOR,CT 06074
PHONE 860-693-2027
WORK DESCRIPTION: NEW SEWER CONNECTION
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY"EXPENSES INCURRED BY THE TOWNFOR-MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
11/23/2016 12:42 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPEMON REPORT
PERMIT NO:: ��� ' I CONTRACTOR:
LOCATION: 3 -h c4 ,/)6 h 1 .
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN .
PROGRESS:
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SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT: DATE: 2,'o, Ila
S/moltoy/forms 2014 Town of South Windsor INPSEMON-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:
of #
Street No. Street Nam
Premises owned by: , �Q
t�
Name of Firm: o Phone:
Address.of Firm: Q A
TYPE OF WORK:
Lay House Drain X Repair House Drain
Lay Main. _ Lay.Lateral-for Commercial/Industrial
Building of acres
Connection will be made with li
Existing Water Supply: Public Water___ Well
Proposed Start Date —2. Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS ALL OSHA REQUIREMENTS AND NDITIONS ATTACHED TI THE PERMIT
Permit is to be issued to r� r?�
Layer's License No. 2 7 the holder of Drain
. 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.
- d
Signed: A, Print Name: fG ,
Licensed Drain Layer
Date:
Standard FormsTermits\APPLICAIION FOR DRAIN LAYERS PERMir.doc
TOWN OF SOUTH WINDSOR
?` SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS ��
STREET 0ji I po'n 's
SUBDIVISION: k eS-
NORTH ARROW
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STREET ADDRESS SIGt9TURr
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TOWN STATE ZIP INSPECTED BY TOWN
V6-o 6' Lq DATE
'TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
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