HomeMy WebLinkAboutDrain Layers Permits 1000 Longleaf Lane (2) 1700037 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 07/17/2017
GIS ID: 54651000 FEE: 60.00
MUNIS APPLICATION# 201700919 EXPIRATION DATE: 08/16/2017
APPLICANT LOCATION
NAME: BCI INC DBA BUTLER COMPANY ADDRESS: 1000 LONGLEAF LANE
ADDRESS: 848 MARSHALL PHELPS ROAD OWNER: RHD SOUTH WINDSOR LLC
WINDSOR,CT 06095 4520 EVERHARD ROAD#147
CANTON,OH 44718
PHONE
WORK DESCRIPTION: SEWER CONNECTION FOR CAMBRIA SUITES
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.
ISSUED BY T DATt INSPECTED INSPECTED BY
7/17/2017 11:41 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: i 1 Qc,0_ 5 j CONTRACTOR: _3;(t/fir
LOCATION: 6
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:
c
SEPTIC TANK PUMP , SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/molloy/forms 2014 Town of South Windsor INPSECTION REPORT 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: ZQQ o 1 Cana ZPa,� L Lot #
Street No. Street Name
Premises owned by:
Name of Firm: - 6// l�i> ✓/4 i� �cf' Phone: v 0
Address of Firm: f
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water Well
Proposed Start Date J,, 17 Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMEN LD ONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to �� C`c� etic the holder of Drain
Layer's License No. 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. 'h �11�'J� ' PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST AIR TESTED
Signed; Print Name:
i nsed Drain Layer
Date:
Standafds�Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET
SUBDIVISION: 4�� ��
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