HomeMy WebLinkAboutDrain Layers Permits 50 Andrews Way (10) 1600034 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 06/23/2016
GIS ID:03200050 w FEE: 60.00
MUNIS APPLICATION# 201600845 y iw EXPIRATION DATE: 07/23/2016
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APPLICANT LOCATION
NAME: BUTLER COMPANY i ADDRESS ., Or ANREWS WAY
ADDRESS: 848 MARSHALL PI&Lat—IysS zO: MUTA WINDSOR DEVELOPERS LLC
WINDSOR,CT 06045 ` 2¢ 1fAIN STREET SUITE 100A
is CH ....HAM,NJ 07928
PHONE 860-68$ 8024 2
WORK DESCRIPTION: NEW SiWER qOmCTION C01VIM>;RJCiL BIILDINCr#5 UNITS 501 —504
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THE DRAIN LAYER ASSIGNED TO THIEIII HAS A VALID T,ICEi+SE ISSi)ED BY� II STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH INHE. T I'ACHED zONDITI.ONS' I L ARK SHALL BE 1N ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDtDS,1I.Vi,L OSHA REQUIREMIIITS1L`ID ZFiE ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
6/23/2016 8:43 AM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: CONTRACTOR:_ Gtl��
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: r
INSPECTED BY: /3 p
WORK IN
PROGRESS: ,z 3 ,2
-1To.' cK 9'
' arc
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT: -- DATE:
S/molloy/forms 2D14 Town of South Windsor INPSECTION 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:-- � � $ ��•
Street No. Street Name
Premises owned by: ----'1-x? 42'
Of
Name of Firm. Ph
one:
Address of Firm:
TYPE OF WORK:
Lay House Drain ; Repair House Drain
wM Lay Main Building-__
• Lay Lateral for Commercial/Industrial
s Building __ of acres
.�..�.
Connection will be made with t �"
Existing Water Supply: Public Water gam_ Well
Proposed Start Date�A Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WIPH.TOWN OF SOUTH WINDSOR STANDARDS
ALL OSHA REQUIREMENTS AN�CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to emlr -.�ee � the holder of Drain
t` Layer`s License No.
. Only holders of Pj7aA6Y�S
-9 licenses
wii! be issued a permit. PERMIT WILL E3CPIRE THIRTY 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 CohnDOT Permit No.
PLEASE NOTE:
,« CBYD No. F f f 3FA SA/YITAR 'MER.LATERAL
IS W1THIAf 75 FEkT OF WELL
ITAdusrBfArR TESTED
Signed:
9 - ' Print Name.
n ed Drain Layer
Date: f
standard Forms\PermiwPPucATIoN FOR DRAIN LAYERS PERMIT.dot
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATI.ON
DATE OF CONSTRUCTION: Jvvk 8 2ot�
BUILDING ADDRESS -
STREET
SUBDIVISION: m5!m �Vr [zGC,CI�N Wo9i-k
NORTH ARROW
APR
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13VrLE-9 CAMA4,V l (601
CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
" MAtSNAL: NEIA ROAD ^l
STREET ADDRESS SIGNATURE
1411mo SC?g._ c2r GYotXl'S /1 DATE
TOWN STATE ZIP INSPECTED BY TO
DATE
e - 28._._._. . ._
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER