HomeMy WebLinkAboutDrain Layers Permits 71 Longmeadow Drive (2) 1900009 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 01/08/2019
GIS ID: 54670071 FEE: 80.00
MUNIS APPLICATION# 201900029 EXPIRATION DATE: 02/07/2019
APPLICANT LOCATION
NAME: SSC CONSTRUCTION LLC ADDRESS: 71 LONGMEADOW DRIVE
ADDRESS: 1700 SAYBROOK ROAD OWNER: TOLL LAND XVIII LIMITED PARTNERSHIP
42 OLD RIDGEBURY ROAD
MIDDLETOWN,CT 06457
PHONE
WORK DESCRIPTION: NEW SEWED 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`CONDITION,8'. ALL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHA REC UIREMENTS,AND THE ATTACHED CONDITIONS.
ISSUED BY ATE INSPECTED SPECTE BY
1/8/2019 8:34 AM
TOWJM OF SOUTH WINDSQR INSPECTION REPORT
PERMrr NO.: CONTRACTOR:
LOCATION: / l ,l)v"1 V --
TYPE OF WORK::
DATE INSP NEM. DATE INSP: I 9
INSPECTED BY: :b
WORKIN
PROGRESS:_ Cc,
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SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES [] N0
AS-BUILT: .
INPUT: DATE:
S/m6NWfibrm=4 Tom of South Wmdw.INPSECRnN 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 proposed work: `71 1019tn{w4e-✓ J/� Lot #
Street No. Street Name
Premises owned by: k-o I.
Name of Firm: .SSC Can sjrvr-4 d� t l C_._ Phone: 2,7
Address of Firm: i ?U of �G-t +2
TYPE OF WOR VA ;
Lay House Drainepair 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 F010
Existing Water Supply: Public Water_ Well
Proposed Start Date 6? 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 S4 t c e- r+.n, the holder of Drain
Layer's License No.}'4,-? 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. 20 i(fjo ZO e Y73 PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE AIR TESTED .
Signed: 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 i;
BUILDING ADDRESS -i/
STREET ,'ve
SUBDIVISION: .
NORTH ARROW
i
:
1 1
CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
TOWN STATE ZIP INSPECTED BY TOWN �-
t °' G 3 J DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER