HomeMy WebLinkAboutDrain Layers Permits 50 Andrews Way (9) 1600037 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 06/23/2016 'f 'y41
GIS ID: 0320005Q ' FEE: 60.00
MUNIS APPLICATION# 201600848 s EXPIRATION DATE: 07/23/2016
.
APPLICAM' 5 ; LOCATION
NAME: BUTLER COMPANY'r .; ADDRESS ..-k $0 ANREWS WAY
ADDRESS: 848 MARSHALL PHEL�'S 1t0AD' OWNEROUTI WINDSOR DEVELOPERS LLC
WINDSOR,CT 06095 4 261VIAIi STREET SUITE 100A
' iAHAM,N7 07928
PHONE 860-68 8024w F _
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WORK DESCRIPTION: NEW SI{WRR GQ1NCTIO COMM1rIZCAT,IL� DLN 7iJNITS#701-708
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THE DRAIN LAYER ASSIGNED TO THI4PF411T HAS A �1LIp I IENS ISSU :BY THL STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FOihf II+ITHE ATTACHED'CONDTTIOTSTS' 4LL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS, I;L OSHA REQUIREMENTS AIp THE ATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED BY
6/23/2016 8:56 AM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.; Z� 00OS2 CONTRACTOR: 160 14P2
LOCATION: S 0 #q n clr
TYPE OF WORK:_ A)etD LetJeA , rb nneL oll f�
DATE INSP NEEDED: DATE INSP: 3 34 f 7
INSPECTED BY: 67D
WORK IN /
PROGRESS:
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/molloylfnrms 2014 Town of South Wlndsor INPSEMON REPORT 14
APPLICATION FOR DRAIN LAMER 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 Nam
Premises owned by: L�
Name of Firm: ' :T � �, ��
Phone:.
Address
of Firm:
7YPE OF WORK:
Lay House Drain Repair House Drain_
F
Lay Main ' Lay Lateral for Commercial/Indusbial
Building of acres
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Connection will be made with
Existing Water Supply: Public Water Well_
Proposed Start Date. �,4 maw time for completion
ALL WORK TO BE IN ACCORDANCE WnN TOWN,OF SCfUTH WINDSOR STANDARDS,
::. ALL OSHA_REQUIREMENTS AN CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to �i ;� ��.�. the holder of Drain
{ ; Layer's License No. 062 7Only holders of P- , PA
"'W-9 licenses
will be issued a permit. PERMIT'WILL EXPIRETHIRTY'{ YS WER
<` 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.
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PLEASE NOTE:
a CBYD No. lFA SAAf1TARYSY&WER.L4TER4L
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Signed: - a
--� Print
l�c n d Drain Layer
Date:
Standard Fvrms\PermiWPPLICAn0N FOR DRAIN LAYERS PERMYT.dcx,
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 3 L3c, 11,7
BUILDING ADDRESS r
STREET
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SUBDIVISION:
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CONTRACTOR (PRINT) Of NT OR'S PERVISOR (PRINT)
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TOWN STATE ZIP INSP ED Y TOWN
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TELEPHONE NUMBER
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: /ag
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STREET
SUBDIVISION: Mpd
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TELEPHONE NUMBER'
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WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER