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HomeMy WebLinkAboutDrain Layers Permits 160 Loomis Road (2) 1700056 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 10/18/2017 ; GIS ID: 54700160 FEE: 80.00 MUNIS APPLICATION# 201701472 , r EXPIRATION DATE: 11/17/2017 {. .< APPLICANTLOCATION NAME; JACQUES CONSTRIG��01�T ADDRESSb0}LOQMIS ROAD ADDRESS: 67 RIDGE ROAD OWN) JACQUIJS CONSTRUCTION LLC SOUTH WINDSOR,CT 06.074 67 RIDGE ROAD S©UHWINDSOR,CT 06074 PHONE 860-43 2314 WORK DESCRIPTION: NEW SiWrCUiECTION 9 THE DRAIN LAYER ASSIGNED TO THISSPFIIT4 HAS A VA7 ID LT 'EISE:ISSUI ;BY,THE STATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FORti'1N TI ::ATTACI�ED�COI�iDITIONS' ALL WORK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHA'REQTIREMEN I S, D THE ATTACHED CONDITIONS. i ISSUED BY DATE INSPECTED INSPECTED BY 10/18/2017 3:13 PM � r:w gz r '� $t r5, ice' p 1 k D V�6 V. 1 F S TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: I -7OPOS(0 CONTRACTOR: LOCATION: /(c) L od m i,j, TYPE OF WORK:_ A-60 DATE INSP NEEDED: DATE INSP: INSPECTED BY: 3D WORK IN PROGRESS: f A14,Ik-d f'VC sb �tv 5 b Q 4 SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES 0 NO AS-BUILT: INPUT: DATE: - S/molloy/forms 2014 Town of South Windsor lwsb m REPORT 14 APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $80.00 Location of proposed work: ,r1,17 0 Z' aaml Lot # Street No. Street Name / Premises owned by: ��6'°4�G !�1 l.� Name of Firm: J'(4 Phone: Address of Firm: 2 z7l d TYPE OF WORK: Lay House Drain ; Repair House Dr Lay Lateral for building with connection; or no connection Lay Main Lay Lateral for Commercial/Industrial Building number of acres Connection will be made with 15, S Existing Water Supply: Public Water Well Proposed Start Date ldl,0112 Estimated time for completion IQA 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 J n 3-tcco V the holder of Drain Layer's License No. a0983 0 . Only 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 terms and conditions set forth in the permit and attached thereto. Applicant has received Town Street Excavation Permit No. and/or ConnDOT Permit No. CBYD No. PLEASE NOTE: IF A SANITARY SEWER LATERAL IS WITHIN 7S FEET OF A WELL IT MUST BE AIR TESTED Signed: Print Name: o J� up Livens rajnk-ayer Date: Standard Forms\Permi \APPLICATION FOR DRAIN LAYERS PERMIT REVISION 2017,doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS 166 STREET : �� J (0. SUBDIVISION: r s'� NORTH ARROW I 1 , 111 CQNTRA R RINT C✓' // NAME OF CONT, CTOR' SU KVISO (PR- 11) STREET ADD ESS ,j SIGNATU I DATE t TOWN T E ZIP A4 INSPECTED BY TOWN DATE TELEPHONE OMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER