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HomeMy WebLinkAboutDrain Layers Permits 66 Longmeadow Drive (2) 1900010 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 01/09/2019 GIS ID: 54670066 FEE: 80.00 MUNIS APPLICATION# 201900046 EXPIRATION DATE: 02/08/2019 APPLICANT LOCATION NAME: SSC CONSTRUCTION LLC ADDRESS: 66 LONGMEADOW DRIVE ADDRESS: 1700 SAYBROOK ROAD OWNER: TOLL LAND XVIII LIMITED PARTNERSHIP 42 OLD RIDGEBURY ROAD MIDDLETOWN,CT 06457 PHONE WORK DESCRIPTION: NEW SEWER CONNECTION 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 WO SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDARDS,,ALL OSHA REQUIREMENTS,AND THE ATTACHED CONDITIONS. lro A2 b ISSUED BY DATE IN PECTED INSPECTED BY 1/9/2019 9:56 AM TOWN OF SOUTH VIrINDSOR INSPECTION REPORT PERMIT NO.: I `���o�� CONTRACTOR: �S LOCATION: L©n 4 MraazJ TYPE OF WORK: C© h twee t'J n DINE INSP NEEDED: DATE INSP: ° INSPECTED BY: WORK IN PROGRESS: jL SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES n NO- AS-BUILT: INPUT: DATE SrrMWfibrms 2M4 To=of South ftdw MPSWM 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 work: 6 G ���` °`'' Opt Lot # 35 proposed Street No. Street Name Premises owned by: Name of Firm: SSc COOf hr���,1'v� l (C-- Phone: ?20" D-0 Z313 Address of Firm: 1760 /tom 01,e le/4�4Cv✓j CT TYPE OF WO 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 Connection will be made with S�/1 Existing Water Supply: Public Water Well Proposed Start Date / 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 the holder of Drain Layer's License No. kw l 0&701- 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. 2co(c(0Z0 11,( 69 PLEASE NOTE: IF A SANITARY SEWER LATERAL IS WITHIN 75 FEET OF A WELL IT MUST BE AIR TESTED Signed: Print Name: ,Sarcat�-c Licensed Drain Layer Date: �' Gl• CGj Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT REVISION 3/2D18.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS STREET : �-�` '✓ SUBDIVISION: _ „ , ®eC-u'� d NORTH ARROW ; j j bill, { i 1 y j � I �f i j i I I � %i •�' ' i : I -t-- } CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT) STREET ADDRESS SIGNATURE TOWN STATE ZIP INSPECTED BY TOWN DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER