HomeMy WebLinkAboutDrain Layers Permits 24 Schoolhouse Driv (2) 1800101 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 12/14/2018
GIS ID: 81200024 FEE: 80.00
MUNIS APPLICATION# 201802428 EXPIRATION DATE: 01/13/2019
APPLICANT LOCATION
NAME: EAGLE EARTHWORK SERV ADDRESS: 24 SC140OLHOUSE DRIVE
ADDRESS: 101 N MOUNTAIN ROAD OWNER: MANNARINO BUILDERS INC
400 CHAPEL ROAD UNIT 3-F
CANTON,CT 06019
PHONE 860-693+2027
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 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
12/14/2018 10:40 AM
TOWN OF SOUTH WINDSOR INSRECTiON REPORT
PERMIT'NO.: f
CONTRACTOR: z1a / ' �h lc1Da s-
LOCATION:_ ,�Ll_=S h—PD
TYPE OF WORK:
DATE INSP NEEDED: : DATE INSP:
INSPECTED
WORK IN
PROGRESS:
/.ems P ''�-'ESL c�� �'�C'�Lw �---•� .
—_ C G..� I"�~� � ]_G-•7.e', l t?''�"2ri �E'4 '' Lv�r,—..:'L.c-eLi l ✓TT
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES [J NO'
AS-BUILT: . ` j
INPUT: DATE: I A j I �t
S/mdtoy/forms 2M Town of South Mftw WSWM 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: .�`
.—'-� � &t Lot # [
Styr et o. Street Name
AA
Premises owned by:
Name of Firm:—)E r n Phone:
rzd2-1
Address of Firm:_LU �;r`fG, b ra t"'l� � � vif�dl�f'-robol�
TYPE OF WORK.-
Lay House Drain—--; Repair House Drain-
rai • Sanitary Disconnect
Lay Lateral for buil in with connecfio .9 • or no connection
Lay Main
Lay Lateral for Commercial/Industrial Building number of acres
Connection will be made with
Existing Water Supply: Public Water_ well
Proposed Start Dated Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACH® TO THE PERMIT
Permit is to.be issued to &�—the holder of Drain
Layer's License No. ?7dV3 2�6 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. PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE-AIR TESTED .
Signed: �(�
9 � Print Name:_
Licensed Drain La r
Date: /2
Standard Fannsftmit WPLICAIION FOR DRAIN LAYERS PERMIT REVISION 3/2018.doc e
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: i a- ll �i r I
BUILDING ADDRESS `f
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAM �C TRAC 0 S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
�1���� � � �>.,�� '� �'.�--t � ��,��• DATE
TOWN STATE ZIP '— INSPECTED BY TOWN
e r- �� c cif DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER