HomeMy WebLinkAboutDrain Layers Permits 53 Farmstead Drive (2) 1900011 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 01/14/2019
GIS ID: 31800053 FEE: 80.00
MUNIS APPLICATION# 201900063 EXPIRATION DATE: 02/13/2019
APPLICANT' LOCATION
NAME: JAMES THROWE DBA ADDRESS: 53 FARMSTEAD DRIVE
ADDRESS: 1330 MAIN STREET OWNER: " DUBAY"CARMEN A LIU&
53 FARMSTEAD DRIVE
SOUTH WINDSOR,CT 06074
PHONE 860-289-0095 .r
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
1/14/2019 8:12 AM
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TOWN OF SOUTH 1KINDSOR INSPECTION REPORT
PERiwrr No.: `. oto1
. CONTRAGTOR:_, )Gt m�t %�✓�_�
LOCATION: 53.
TYPE OF WORK:_
DATE INSP NEEDED.; DATE IN.SP:
INSPECTED BY: `n al)
WORK:IN
PROGRESS•
SEPTIC TANK PUMPED,SMASHED, FILLED ' WITNESSED ❑YES YNO-
AS-BUILT:
INPUT: 'U-
DATE:' �I'
S/md[CY/f =20141bem of South Winton INPSWTM 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
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• Location of proposed work: �� �r�m t�, t Lot #
Street No. Street Name
Premises owned by: Lk-� "
Name of Firm: V`�� LAI- „,, G Phone: 2Ild,�S
Address of Firm:
TYPE OF WORK:
Lay House Drain z; 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 SQ�C
Existing Water Supply: Public Water X Well
Proposed Start Date/`OW I Estimated time for completion /VJ411�
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. 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. ski o Zoo 7l 2 PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE AIR TESTED
Signed: 1L- Print Name:--., ry
Licensed Drain Layer
Date:_ //,WZ
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT REVISION 3/2018.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS � Ma
STREET : _ 4 ✓' f'�� '��'��r.
SUBDIVISION: AvA
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CONTRACTOR (PRINT) NAME OF CONTRACTPR'S SUPERVISOR (PRINT)
STREET ADDRESS SIG MATURE
yi r .� :-f �. _ /. DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER