HomeMy WebLinkAboutDrain Layers Permits 175 Oakland Road 1800018 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 04/10/2018
GIS ID: 65700175 FEE: 80.00
MUNIS APPLICATION# 201800373 EXPIRATION DATE: 05/10/2018
APPLICANT LOCATION
NAME: GERBER CONSTRUCTION CO ADDRESS: 175 OAKLAND ROAD
ADDRESS: 1 NUTMEG DRIVE OWNER: BERRY PATCH III LLC
ELLINGTON,CT 06029 6 EXECUTIVE DRIVE SUITE 100
FARMINGTON, CT 06032
PHONE 860-875-6684
WORK DESCRIPTION: NEW SEWER CONNECTION FOR BERRY PATCH III
(BUILDING(4)401-408
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.
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ISSUED BY DATE INSPECTED INSPECTED BY
4/10/2018 12:13 PM
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: 1-7 S A<LAfy'0 fk A Lot # S LO lf 4
Street No. Street Name
Premises owned by: e tyr j R%k t,
Name of Firm: 74 /144o Coss y.� 6'Oc P Phone: 6L 7 ft4
Address of Firm: cT 03-L
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
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 Tv rn t o
Existing Water Supply: Public Water____ Well
Proposed Start Date •�`� ' Estimated time for completion 1 3r 1e
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 d-6'ev (a �s�+v ��^ +� . the holder of Drain
Layer's License No. o-Lo t- P7 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. 70 1.9 5 PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE AIR TESTED
Signed: Print Name: go—
Licensed Drain Layer
Date: I/Yhs
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT REVISION 2017.doc
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I ODO I CONTRACTOR: (e'SP_c be
LOCATION: 116- L.Ia r�
r
TYPE OF WORK: 1 d
DATE INSP NEEDED: DATE INSP: / 3 )1
INSPECTED BY: ,,�_
WORK IN
PROGRESS:_(', �-ryj✓ o'n_ �-a c� (F �� l�,�c: ���'2
Vic.✓i � c�.- � ���i�6 �G � — "r �.0
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT: Cam-- DATE:
5/mo0cy/forms 2014 Town of South WirdSOr INPSEGTION REPORT 14
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: (9 - <<
BUILDING ADDRESS PS
STREET : [-' S
SUBDIVISION: '3eIrY Lf
NORTH ARROW
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,
I r
:
CONTRACTOR (PRINT) NAME OF ONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS q SIGNATURE
E,%'Nb f Vr\ �- O" 1 ,,!`- '��r=Xz R/,s/id DATE
TOWN STATE ZIP INSPECTED BY TOWN
60 - $-7 S-6(off`t DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER