HomeMy WebLinkAboutDrain Layers Permits 200 Deming Street 1300032 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 09/27/2013 �
GIS ID;27600200 4 , FEE: 60.00
MUNIS APPLICATION 4 20I301399 r � % EXPIRATION DATE: 10/27/2013
APPLICAN LOCATION
NAME: BUTLER COMPANY RE M 2 0 DE 301LAZA
NG STREET
ADDRESS: 848 MARSHALL PHA` U x LLC
WINDSOR,CT 06095, �� �q-kRET AVENUE
�A5.0 AbE,NY
PHONE 860-68$ 0?4 F k g
WORK DESCRIPTION: NEW SE IO «
. �
THE DRAIN LAYER ASSIGNED TO THIS P_ QiA TATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS A�SET FORT TT SHALL BE IN ACCORDANCE WITH
H _' A - A 1�Q'
THE TOWN OF SOUTH WINDSOR STAND AR�• ��., ���� � ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
9/27/2013 10:41 AM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: / 0Wl31___;L_ CONTRACTOR: AA*k0(?_
LOCATION: ( Q 1)2
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: 10
INSPECTED
WORK IN
PROGRESS: 0_(,- rc�cd6r
cn k lk t~.�^�S
F C00
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: '`.... DATE: �1
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVAN AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: ; N �#
Street No. Street me
Premises owned by: .t2�'
a .7/�
Name of Firm: �,/Phone egg(5 y
Address of Firm: z �' �c c
TYPE OF WORK: (�
Lay House Drain-------; Repair House Drain
Lay Main W; Lay Lateral for Commercial/Industrial
Building .: of acres
Connection will be made with �cwr
Existing Water Supply: Public Water Well
Proposed Start Date Estimated time for completion
ALL WORK TO BE IN ACCORD E WITH.TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA.REQUIREMENTS NDTIIONS ATTACHED TO THE PERMIT
Pemit is to be issued to Dt the holder of Drain
Layer's License No.
A holders of P-i, P-7 or W-9 licenses
will be issued a permit. PE MIT 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.
---------------
PLEASE NOTE:
CBYD No C IFA SANITARYS 'WER LATERAL
IS WITHIN 75 FEET OF WELL
IT l�fU FAIR TESTED
Signed: Print Name: D0,0,07-
+ used rain Layer
Date: i
standard Forms,PermiWAPPLICATION r-oR BRAIN LAYERS PERMIr.doc
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: s 0 - .21._ 1.5
BUILDING ADDRESS �� `t�e► � �9 `�fi
STREET
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SUBDIVISION: + 2c5+ c l(2,
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NORTH ARROW
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CONTRACTOR M07�a
` NAME F CO TRA TO 'S SUPERVISOR (PRINT) -
STREETmt
ADD ES S SIGN TURE
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TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING .ENGINEER / DEVELOPER
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