HomeMy WebLinkAboutDrain Layers Permits 17 Longmeadow Drive (2) 1900007 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 01/07/2019
GIS ID: 54670017 FEE: 80.00
MUNIS APPLICATION# 201900023 EXPIRATION DATE: 02/06/2019
APPLICANT LOCATION
NAME: SSC CONSTRUCTION LL.0 ADDRESS: 17 LONGMEADOW DRIVE
ADDRESS: 1700 SAYBROOK RC AI7 OWNER: TOLL,LAND XVIII LIMITED PARTNERSHIP
42 OLD RIDGEBURY ROAD
MIDDLETOWN,CT D6457
PHONE
WORK DESCRIPTION: NEW SEYVE CONNI CTION
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 DATE INSPECTED INSPECTED BY
1/7/2019 11:39 AM
: TOWN OF SOUTH-WINDSOR INSPEC WN REPORT
PERMIT NO.: CONTRACTOR:
LOCATIONS-
TYPE OF WORK:
DATE IIVSP NEEDED: DATE IIVSP: I i
INSPECTED
WORK IN
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INPUT: _ _
gfibnms M TOM of SloUth Wkdw MSEMM REPORT 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, Cr
FEE $80.00
Location of proposed work:_ Lot #
Street No. Street Name
Premises owned by: 'To r Bras 'T n e-
Name of Firm: cd^ Phone: r6o•Zsa. 7-
Address of Ran:_! 7aa rgk/
TYPE OF WORK:
Lay House Drain ; Repair House Drain • Sanitary.pisconnect
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 6 '` s011
Existing Water Supply: Public Water Well
Proposed Start Date I• '7 1! Estimated time for completion
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 sa �-- Cam., •. • r-a the holder of Drain
Layer's License No. 1010*1•oz8'?-Py/-rP7. 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. 7-o fl oZoo t-0 3 PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE-AIR TESTED .
Signed: Print Name: St fir• „• '�'m
Licensed Drain Layer
Date: 1• " . !
Standard F0ffnS eMbWPPLICA-rMN FOR DRAIN LAYERS PERMIT REVISION 3/2018.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: h / o/
BUILDING ADDRESS / 7
STREET : Lo � �
SUBDIVISION:
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CONTRACTOR (PRINT) NAME CONTRACTOR'S�1111R�N\110R (PRINT)
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STREET ADDRESS { SIGNATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
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TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER