HomeMy WebLinkAboutDrain Layers Permits 161 Mcgrath Road 1800098 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 12/07/2018
GIS ID: 58200161 FEE: 80.00
MUNIS APPLICATION# 201802373 EXPIRATION DATE: 01/06/2019
APPLICANT LOCATION
NAME: INCORPORATED INDUSTRIES,LLC ADDRESS: 161 MCGRATH ROAD
ADDRESS: 180 W NEWBERRY ROAD OWNER: 13OULA S JAMES A&CATHERINE L
161 MCGRATH ROAD
BLOOMFIELD,CT 06002-1331
PHONE 860-242�0150
WORK DESCRIPTION: REPAIR HOUSE DRAIN
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 BV DATE INSPECTED INSPECTED BY
12/7/2018 3:02 PM
TOWN OF,SOUTH-WINDSOR INSPECTION REPORT
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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: V� Lot #
Street No. Street Name
Premises owned by: el" ;L_S" /0)- '
Name of Firm: rc�� orm 0 �1 G LAC Phone:
Address of Flrm: /�� ��� �L-�
TYPE OF WORK:
Lay House Drainer 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
Existing Water Supply: Public Water Well
Proposed Start Date Estimated time for completion mom. ��y
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 �"�' ��' � � LAC the holder of Drain '� �
Layer's License No. P7 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, Print Name: � � �
Licensed Drain Layer Z6�06 7
Date: /2/ /o1'
Standard Forms\P ffftWPLICATION FOR DRAIN LAYERS PERMIT REVISION 3/2018.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 19 lit//A
BUILDING ADDRESS /61
STREET : C 6 A ac jj)
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DATE
TOWN STATE - ZIP `
INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER