HomeMy WebLinkAboutDrain Layers Permits 154 Kelly Road 1600091 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 12/07/2016
GIS ID:49500154 FEE: 0.00
MUNIS APPLICATION# 201601789 EXPIRATION DATE: 01/06/2017
APPLICANT LOCATION
NAME: SPAZZARINI CONSTRUCTION ADDRESS: 154 KELLY ROAD
ADDRESS: 50 POST OFFICE ROAD OWNER: MATTHEWS NANCY J
ENFIELD,CT 06082 154- KELLY ROAD
SOUTH-WINDSOR, CT 06074
PHONE 860-745-5683
WORK DESCRIPTION: REPAIR LATERAL 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 INTHE ATTACHED`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 INSPECTED PECTED BY
12/7/2016 11:33 AM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO;:,11161) CONTRACTOR:— z> r,J ►� ►
LOCATION:
TYPE OF WORK: Y-��m r; ,a1 --
DATE INSP NEEDED: & Z. DATE INSP:
INSPECTED BY: as �z�p
WORK IN "
PROGRESS: W;zt Coni6= a
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SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT: ''
INPUT: 1 ,
DATE.
S/moBoy/fmms 2014 Town of South Windsor MECRON 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: S4 Lot #
Street No. Street Name
Premises owned by:
Name of Finn:_ Phone: S6 c
Address of Firm.-_ 31� ?0s�7. QszF,
TYPE OF WORK:
Lay House Drainer Repalr.House Drain
Lay Main • Lay Lateral for Commercial/Industrial ,
Building of acres
Connection will be made with _Sr--)9, -3
Existing Water Supply: Public Water y 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. W Only holders of P- - r W-9 licenses
will be issued a permit. PERMIT WILL EXPIRE THIRTY(30)1 YS 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. cP�0 a-1 y O ,\o a-"7 IFA SANITARYSEWER LATERAL
IS WITHIN7S FEE T OF WELL
IT MIST BEAIR TESTED
Signed: Print Name:
1. rain Layer
Date:
Standard Forms\PermitAAPPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET
-I- SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) . �Sfi NAM OF CON RA OR'S SUPERVISOR (PRINT)
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STREET ADDRESS SIGNATURE
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TOWN STATE ZIP INSPECTED BY TOWN
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TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER