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HomeMy WebLinkAboutDrain Layers Permits 146 Kelly Road 1600090 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 12/07/2016 GIS ID: 49500146 FEE: 0.00 MUNIS APPLICATION# 201601788 EXPIRATION DATE: 01/06/2017 APPLICANT LOCATION NAME: SPAZZARINI CONSTRUCTION ADDRESS: 146'KELLY ROAD ADDRESS: 50 POST OFFICE ROAD OWNER: DESMARAIS GARY&BRENDA ENFIELD,CT 06082 146 KELLY ROAD SOUTH WINDSOR, CT 06074 PHONE 860-745-5683 WORK DESCRIPTION: LATERAL REPAIR NO FEE TOWN PROTECT 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. L a ISSUED BY DATE INSPECTED j SPECTED BY 12/7/2016 11:37 AM TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO;: & 0 00 ° CONTRACTOR:_5 D 47z., Y � � LOCATION: 1 to ._ig 11 a o a TYPE OF WORK: a Az . ��eL i r DATE INSP NEEDED: 9>-3c, DATE INSP: 13-3a-1 Z INSPECTED BY.--AW As WORK IN PROGRESS; Wo(z� V&-A-,ED ►C> K-Fzl ly C4 �N�G'►z'G",rrro S�� �,V,,� F^�►�f -G1 � NrPF-�T�� SEPTIC TANK PUMPED,SMASHED, FILLED L WITNESSED ❑YES ❑ NO AS- BUILT:-INPUT:,- DATE: ' S/molloy/forms 2014 Town of South Windsor INMEMOWREPORT 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: -Lot # Street No. street Name Premises owned by: NameofFirm:__. SS A2z.vs.i�\-+1t Phone: '!F6a- 7'-67-�96�'3 Address of Firm: Fs Poste.o c i cj_r, i� J 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 the holder of Drain Layer's License No. A-11 ©27 gr z Z Only holders of P-1.J52�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. o t i q 0 IFA SANITARYSEWER-LATERAL IS WITHIN75FEET OFA WELL IT MUST SEAIR TESTED Signed: Print Name: _.UAMOY Lic in Layer Date: Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS U, vS STREET SUBDIVISION : NORTH ARROW -Z4 - 1 , I ? t�,2`Z CONTRACTOR (PRINT) NAME OF CON RA ORBS SUPE VISOR (PRINT) .3 STREET ADDRESS SIGNATURE Co 0 DATE TOWN STATE ZIP INSPECTED BY TOWN ro0 3 DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER