HomeMy WebLinkAboutDrain Layers Permits 180 Pepin Place (2) 1600074 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 11/17/2016
GIS ID: 70700180 FEE: 0.00
MUNIS APPLICATION# 201601713 EXPIRATION DATE: 12/17/2016
APPLICANT LOCATION
NAME: T&M BUILDING CO.,INC. ADDRESS: 180 PAPIN PLACE
ADDRESS: 110 BROOK STREET = OWNER: -T&M BUILDING CO INC
TORRINGTON,CT;06790 110 BROOK STREET
TORRINGTON,CT 06790
PHONE 860-883-5910
WORK DESCRIPTION: NEW SEWER-CONNECTION BUDDING 4 PERMIT FEE COLLECTED ON
APPLICATION 201601711 SO--WINDSOR WOODS
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 VV RK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHA REQUIREMENTS,AND THE ATTACHED CONDITIONS.
c &
ISSUED BY DATE INSPECTED SPECTED BY
11/17/2016 10:36 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
CONTRACTOR.PERMIT NO:: � � 7 �?
LOCATION: i !e&f it
TYPE OF WORK: , °ewe r. C'a i?�► I n c�1 /SU f�,n fT`�
DATE INSP NEEDED: DATE INSP: -vim
INSPECTED BY:_ if_
WORK IN
PROGRESS: t s- IN. }.A&fp cV1 s,'�r�E , tI V vt 144 'At_
SEPTIC TANK PUMPED,SMASHED, FILLED /4- WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT:
S/molloy/fa ms 2014 Town of South Windsor INPSEMOWWORT 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: X 72 /7C y aw-,-17.?Lot #
Street No. Street Name /.,FV4 PAec.
Premises owned by:
Name of Firm: ����� �- � . Phone:
Address of Firm:
TYPE OF WORK:
Lay House Drain '/ ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
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 REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to ram/�,�'7� .�acca.�.. T. the holder of Drain
Layer's 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 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. �7c3/���5'0/S�3SS PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE AIR TESTED
Signe Print Name:
Licensed Drain La
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: (6
BUILDING ADDRESS 11L OIL W , I`i ozli,
N STREET u,
SUBDIVISION: a F
NORTH ARROW -3, 1tUn�
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CONTRACTOR (PRINT) NAMr67F C TRACTOR'S SUPERVI INT)
STREET ADDRESS E ,
17
DATE
TOWN ( STATE ZIP INSPECED Y TOWN
40�Q �" O��Kb DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER