HomeMy WebLinkAboutDrain Layers Permits 49 Edgewood Drive 1400027 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 07/30/20I4
GIS ID: 29400049riXk
� FEE: 60.00
MUNIS APPLICATION# 201401035 {Y ,z �, � t EXPIRATION DATE: 08/29/2014
APPLIC LOCATION
NAME: JAMES THROWS D Aw xy � {� DRE� } D k-,EWOOD DRIVE
ADDRESS: 97 RIVERSIDE DRI � WANN FRANK J&CAROL ANN
�'VERNON ROCKVIL 0 0 'EDWOOD DRIVE
� VINDSOR,CT 06074
PHONE 860-28 009` �
WORK DESCRIPTION: REPAI MMM, bN TO HOUSE
CONNE G A1` i �Y1tyF rr f i _ rye:
,v+1az
THE DRAIN LAYER ASSIGNED TO THI E I S A TIC I I I I ;lssv 1�I� T STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORI� 1�°T f( I� �` IIS , LL ,_bRK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDA� O8 IF A` ( TIR IV%MIt , D ATTACHED CONDITIONS.
tk
ISSUED BY DATE INSFFECTED INSPECTED BY
7/30/2014 3:56 PM
04
of
4�n F4f � n y Cy
s.
�S N S� G4
"0' F Y ws
g
t` *�
i 7 tf
Yp
�'xti �. � � � � sa t ter lS� ,a; a•n,Y e't e ��}'
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: .J C?YP �Xr&61P
LOCATION: y f' 1)1 ,
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:* QjP
WORK IN
PROGRESS: o i r �:�� �. AA" 6 , q
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: I� DATE:
S/2814 Town of South Windsor INPSECTION REPORT 14
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: w �G Lot #
Street No. treet Name
Premises owned by:- 1
Name of Firm: Gkv, zQ L G Phone:
Address of Firrn:J2 LLr
TYPE OF WORK: x
Lay House Drain ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with V/{
Existing Water Supply: Public Water Well
Proposed Start Da I JL Estimated time for completion tau
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 tot the holder of Drain
Layer's License No, Only holders of P-1, P-7 or W-9licenses
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.
PLEASE NOTE:
CBYD No. IFA SANITARYSEWER LATERAL
IS WITHIN75 FEET OF WELL
IT MUST BEAIR TESTED
Signed: Print Name:
Licensed Drain Layer
Date: !
Standard Forms\PermitAAPPLICATION FOR DRAIN LAYERS PERMITADC
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET : EAp-a-IA) A .nr;ve,
SUBDIVISION:
NORTH ARROW
WA
,
I �
CONTRACTOR (PRINT) J NAME OF CONTRACTOR' SUPERVISOR (PRINT)
.7 j�II�S
STREET
// ADDRESS SIG TURF 1 J
y'z�`+'S c•�i � �r d DATE
TOWN STATE ZIP INSPECTED BY TOWN
Vo -S- DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER