HomeMy WebLinkAboutDrain Layers Permits 949 Pleasant Valley (2) 1900008 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 01/07/2019
GIS ID: 07260000 FEE: 80.00
MUNIS APPLICATION# 201900028 EXPIRATION DATE: 02/06/2019
APPLICANT LOCATION
NAME: EXTREME MAINT LtC.AKA EXTREME ADDRESS: 949 PLEASANT VALLEY ROAD
ADDRESS: P O BOX 66 OWNER: PLEASANT VALLEY
600 CANAL STREET
MILLDALE,CT 06467
PHONE 203-272-8010
WORK DESCRIPTION: SANITARY REPAIR COMPROMISED LATERAL DUE TO ROOTS INSTALLED
2 CLEAN OUTS
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 DATE INSPECTED INSPECTED BY
1/7/20192:55 PM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: ( 1-d 0�10 � CONTRACTOR:LLLme �
LOCATION:
TYPE OF WORK: V
DATE INSP NEEDED. DATE INSP:
INSPECTED BY,, 9'
WORK IN
PROGRESS: z - `�Y
SEPTIC TANK PUMPED,_SMASHED, FILLED WITNESSED ❑YES NO-
AS-BUILT:
INPUT;— DATE:
SA1610Y/ftms 2M Town of South M&W Ws=m RMW 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: 9 Ll Q f leAAa^4 UAA " V?-cA- Lot #
Street No. Street Name
Premises owned by: 1:1 dAd l/ k( .0 6
Name of Firm:_Vx{rewe AAa wA-• I-LL Phone: 2d�-2-7 -17to to
Address of Firm: PC> �,� /0�9 . &60 u l +. AAt It 1
TYPE OF WORK: t • y • t`t- 1 vLs-kal,lR of Z C le-a.vt S
Lay House Drain ; Repair House Drain ; Sanitary Disconnect
Lay Lateral for building with connection— or no connection ;
Lay Main
Lay Lateral for Commercial/Industrial Building number of acres
��-pow%,-- �,a�•w�ro�'u-o-C� IQ.4-c.-Y--a,.l. d-cte � pao-4 5
Connection will be made with
Existing Water Supply: Public Water ✓ Well
Proposed Start Date )� '� z n Estimated time for completion I • I I • 19
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 **yu ��t
he older of Drain
Layer's License No. I P I 2_1q -1 to? Only holdhrs 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. 2.0 lq— 02,CO , 6 2 l PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE AIR TESTED
Signed-_' . 4. �w.. ._ �.... , Print Name:
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT REVISION 3/2018.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 1 /4/
BUILDING ADDRESS q q j
STREET : f lea
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
--: �-
STR ADDRESS SIGNATURE
!N,A dcA-C C.� �` !
00 / DATE
OWN S(TAATTE. ZIP INS ECTED TOWN
`J 3 _���` b ( � DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
Molloy, Catherine
From: callcenter@cbyd.com
Sent: Friday,January 04, 2019 10:28 AM
To: CBYD
Subject: Locate Request - 20190102179
Attachments: 20190102179.PDF
Importance: High
(CALL BEFORE YOU DIG -CT) 01/04/2019 10:26:08
-5G -C1 45 -G5
2-SW SWINDS -W3
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*** REMOTE BATCH ENTRY***
***** EMERGENCY*****
TIME..10:26 DATE..01/04/2019
REQUEST NO...20190102179
LATITUDE..41.808853 LONGITUDE..-72.579712
TOWN......SOUTH WINDSOR
ADDRESS...949
STREET....PLEASANT VALLEY ROAD
NEAREST
CROSS STREET..CLARK STREET
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TYPE OF WORK.....SEWER OTHER MACHINE EXC
AREA IS MARKED...YES
REMARKS:
PLEASANT VALLEY CONDOS, BUILDING 3, EMERGENCY PLUGGED SEWER. WORK TO BE DONE AT SIDE OF BUILDING--
CREW IS ONSITE NOW.AREA IS MARKED
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START DATE......01/04/2019 START TIME..10:30
CALLER..........MR TOM GOLDEN
CALL BACK.......
PHONE#.........203-272-8010
FAX#...........203-272-3925
ALT. PHONE#....203-509-1597
EMAIL ADDRESS...INFO@EXTREMEMAINT.COM
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