HomeMy WebLinkAboutDrain Layers Permits 8 Scott Drive (2) 1400043 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
............
DATE: 11/18/2014
GIS ID: 81600008 FEE: 60.00
MUNIS APPLICATION# 201401633 ;h EXPIRATION DATE: 12/18/2014
APPLICANT'? LOCATION
NAME: JAMES THROWE DBASADDRESS,. 8 SiCOTfi DRIVE
ADDRESS: 97 RIVERSIDE DRIV> - O'WNER: : HAVES IVIICHAEL W&LISA D
VERNON ROCKVILLE,CT 66.066 $ SCOTT)DRIVE
SOUTH WINDSOR,CT 06074
PHONE 860-289 Q095-1
WORK DESCRIPTION: NEW SEWER CONNECTION YF1
•
THE DRAIN LAYER ASSIGNED TO THIS PR1yIITHAS A VALID.LICENSEISSUED BY,' HE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH INgTHE'ATTACHED•`CONDITIONS':;'ALL WIM, SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,ALL,OSHA REQUIREMENTS,AND TfIE ATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED BY
11l18/2014 2:51 PM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:-./.!/OLOV3 CONTRACTOR::aa ff ws 'j-AoW e
LOCATION: =aEa!T
TYPE OF WORK: ki9 Q Se y).g, Lue
DATE INSP NEEDED: DATE INSP: 111a1 ll y
INSPECTED BY: f
WORK IN
PROGRESS: G vvtfe�c-l� �, lW 6''fe✓t S D t? g: 1=:
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES [] NO
AS-BUILT:
INPUT. �, DATE.
S/molloy/farms 2014 Town of South Windsor INPSECIFION 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: S CO G� �-1 Lot #
Street No. Street Name
Premises owned by: C,I
Name of Firm: U�4�5 �, r 7`�� �� 1. �ti� Phone: ��
Address of Firm: f c'G c(11 5 1 CL
TYPE OF WORK:
Lay House Drain .
a� ; Repair.House Drain ,
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with (C
Existing Water Supply: Public Water �` Well
Proposed Start Date - Ah,) �L� Estimated time for completion -2 Ily )
ALL WORK TO BE IN ACCORDANCE WITH.TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
_J
Permit is to be issued to jc, 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.
PLEASE NOTE:
CBYD No. IFA SANITARYSEWER LATERAL
IS WITHIN 75 FEET OF WELL
IT MUST BEAIR TESTED
Signed: �' --J
9 Print Name: _ �)")
Licensed Drain Layer
Date:
standard Forms\Perrnits\APPUCATION FOR DRAIN LAYERS PERMU.doc
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: /
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUP E VISOR (PRINT)
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TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER