HomeMy WebLinkAboutDrain Layers Permits 50 Andrews Way (8) 1600002 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 01/06/2016
GIS ID: 03200050 FEE: 60,00
MUNIS APPLICATION# 201600016 t„ EXPIRATION DATE: 02/05/2016
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APPLICANT kN h LOCATION
NAME: BUTLER COMPANY= ADDRESS -50 ANDREWS WAY
ADDRESS: 848 MARSHALL PHELP' ROAD OWNER SOUTH WINDSOR DEVELOPERS LLC
WINDSOR, CT 0609 2C NfAIIT STREET SUITE 100A
CIA°2H1M,NJ 07928
PHONE 860-68$ $024 r=
WORK DESCRIPTION: SEWERQf'E�)If7N FOR BUILDING 2 UNITS Q1� 4} .�`
THE DRAIN LAYER ASSIGNED TO THIS�PE II T HAS A VgLID LX-..,;SE,�SSUE1 I35� 1'HE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH I'N HE.ATTAUNED CONDITIONS' AI,L ,WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,AL1 OSHA=REQULItEMENTS,t',I+(D TI3' ATTACHED CONDITIONS.
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ISSUED BY DA E INSPECTED INSPECTED BY
1/6/2016 12:16 PM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.; / 49000 CONTRACTOR: &L-f 'Leg
LOCATION: Idd oZ (,` c?D/--l-.) 7
TYPE OF WORK: -Lee") s E'ky c C0 0 V-\eo n
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: fib
WORK IN
PROGRESS: �' � r9,';f �„_c ���1 �� Pyc- Szrz 3 s row, smi
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO -
AS-BUILT:
INPUT: (,� � DATE: r 1
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S/moiloy/forms 2014 Town of South Windsor INPSECRON REPORT 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVAN-AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL
SOUTH WINDSOR,CT
FEE$60.00
4 -?LLocation of proposed work: W� Lot# �
Street No. Street Name
Premises owned by: 2LIgge4a.., "k.
Name of Firm: - 7 Phone:
Address of Firm: G�
Ai—
TYPE OF WORK:
Lay House Drain ; Repair.House Drain :
Lay Main ; Lay Lateral for Commerciai/Industrial
Building of acres
• Connection will be made with -
B(isting Water Supply: Public Water V
Well
Proposed Start Date Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH.TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA.REQUIREMENve�
NDMONS ATTACHED TO THE PERMIT
--�'
Permit Is to be issu torr a the holder of Drain
se
Layer's Licen No. 7 my holders of P-1, P-7. or W-9 licenses
will be issued a permit. PERMIT WILL EXPIRE THIRTY(30) DAYS AFTER
DATE OF ISSUANCE. The undersigned Drain Layer hereby agrees to all the terns
and conditions set forth in the permit and attached thereto.. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
PLEASE NOTE;
CBYD No. IFA SANITARYSEWER_LATERAL
IS WITIYIIU7$FEET 4FA WELL
i IT MUS EAIR TESTED
Signed: i Print Name: q"e7
4• used Drain Layer
Date: d G
Stan0ard F'orms\Pern»ts\APPLrcA1ToN FOR DRAIN LAYERS PERMTr doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS �r �� 2-
STREET
SUBDIVISION: ��
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF ONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS///I r -SIGNATURE /
� D, ATE
TOWN / STATE ZIP INSPECTED BY TOWN
y `-�'CSLLI DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER