HomeMy WebLinkAboutDrain Layers Permits 5 Chaponis Way (2) 1600094 TOWN OF SOUTH WINDSOR, CT
PENT NUMBER DRAIN LAYER PERMIT
DATE: 12/20/2016
GIS ID: 18270005 FEE: 60.00
MUNIS APPLICATION# 201601848 EXPIRATION DATE: 01/19/2017
APPLICANT LOCATION
NAME: EAGLE EARTHWORK SERV ADDRESS: S CHAPONIS WAY
ADDRESS: 101 N MOUNTAIN ROAD OWNER: MANNARINO BUILDERS LLC
CANTON, CT 06019- 400 CHAPEL ROAD#3F
-SOUTHVINDSOR,CT 06074
PHONE 860-693-2027
WORK DESCRIPTION: NEW SEWER CONNECTION
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.
169
ISSUED BY J DAT INSPECTED INSPECTED BY
12/20/2016 8:39 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 6 Ct L CONTRACTOR: �,� /e Vie,
LOCATION:;; �' �,�'„?I
TYPE OF WORK: ��
DATE INSP NEEDED: DATE INSP: /" A"A4
INSPECTED BY: 1
WORK IN
PROGRESS:_f d'17%r��� / ;�I/t> �(�� I h ` l' ✓IL li
dS� l sr/ TF�/`,gA t)4i (�
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT: ✓�
INPUT: L DATE: A.A ')A-
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
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:; C is91. Lot #
Street No.
Street Name
Premises owned by: r
Name of Firm: C
Phone: ar. �,S oZpp
Address.of Firm: o • /� �,
TYPE OF WORK:
Lay House Drain Lay Main Repair House Drain
.
-----__, Lay Lateraf for Commercial/Industrial
. Building of
acres
Connection will be made with 0 T>y
Existing Water Supply: Public Water_
Well
Proposed Start Date ,2 d(j—)V 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 6ib� P tA, � 1
Layer's License No. the holder of Drain
Will be issued,a . Only holders of P-1, P-7 or W-9 licenses
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 h
Town Street Excavation Permit No. Pp as received
and/or ConnDOT Permit No.
CBYD No.
Signed: l
Lice Print Name: M'(C. 4'Qe_jnsed Drain LayerC�
Date:��
standard Forms{PermiMAPPUCA'iION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: P2 ` 1
BUILDING ADDRESS : Lai
STREET .
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SUBDIVISION: GIB
NORTH ARROW
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CONTRA OR (PRINT) NAME OF NTRACTOR'S SUPERVISOR (PRINT)
ST ET ADDRESS SIGNATURE
4 Zk,�b DATE
6�tT 12'
TOWN
9,6-e)
�'1_ STATE -y ZIP INSPECTED BY TOWN
(' .3 � �✓r� / DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER