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HomeMy WebLinkAboutDrain Layers Permits 102 Kelly Road 1600092 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 12/07/2016 GIS ID:49500102 MUNIS APPLICATION# 201601790 FEE: 0.0 EXPIRATION DATE: 01/06/2017 APPLICANT LOCATION NAME: SPAZZARINI CONSTRUCTION ADDRESS: 102 KELLY ROAD ADDRESS: 50 POST OFFICE ROAD OWNER: EDWARDS TRAMS A ENFIELD,CT 06082 713 FOSTER ST PHONE 860-745-5683 SOUTH WINDSOR, CT 06074 WORK DESCRIPTION: LATERAL REPAIR NO FEE TOWN PROJECT 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 WORK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHA REQUIREMENTS,AND THE ATTACHED CONDITIONS. ISSUED BY DATE INSPECTED P CTED BY 12/7/2016 11:35 AM V --- --------------- TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO:: /6 000y-�2Z CONTRACTOR: ,S� Z-z 6z( J(l I- LOCATION:i Gam TYPE OF WORK: I:4•-Z A-P . i C /" . n &i -I- DATE INSP NEEDED: DATE INSP: - -� L INSPECTED BY.'-ALN WORK IN PROGRESS: Woe-k-•, �� f Cr7,�l� � N� � � P � j , Q bw)v ) FAKfi.j rC,141rr-F IrO;K.C,f- SEPTIC TANK PUMPED,,SMASHED, FILLED WITNESSED ❑YES ❑ NO INPUT: DATE: 1 " SJmoffoy/forms 2014 Town of South winter INPSMOWREPOU 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: ©. # Street No. Strbet Name -Premises owned by: Name of Finn:. Sr2y,2z►�bZ�Y.; Phone: Address of Firm:_ 3'& cW TYPE OF WORK: Lay House Drain_; Repair House Drain Lay Main : Lay Lateral for Commercial/Industrial Building of acres Connection will be made with S� 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 the holder of Drain Layer's License No.DGi`l oz,7F73 Only holders of P- ;t; 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. '�0 7. 7 Lf o �. �."� IFA SANITARYSEWER LATERAL IS WITHIN75 FEET OFA WELL IT MUST BEAIR TESTED Si ned• gelf Print Name: ��� � Lice ain Layer Date: Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERmIT.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: 'Nv�_3(,�� ';� c ► 5-- BUILDING ADDRESS RZZ1 6�. STREET -I-- SUBDIVISION: NORTH ARROW i 1 ! { I ! , , s s CONTRACTOR (PRINT) NAME OF CON CT R'S SUPERVISOR (PRINT) STREET ADDRESS SIGNATURE ..x L cl CN-, 0 cc DATE TOWN STATE ZIP INSPECTED BY TOWN a ro a- �7 �l�', 56 -3 DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER