HomeMy WebLinkAboutDrain Layers Permits 135 Sullivan Avenue (2) 1500008 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 03/20/2015
GIS ID; 87300135 FEE; 60.00
MUNIS APPLICATION# 201500211 EXPIRATION DATE: 04/19/20I5
APPLICANT k LOCATION
NAME: ENVIRONMENTAL SEI `IICES 1NC ADDRESS 13$ SULIIVAN AVENUE
ADDRESS: 90 BROOKFIELD STRE OWNER CAST.,MANAGEMENT LLC
SOUTH WINDSOR,CT QGO_74 13 CLARI ST
SOUTH WIVDSOR,CT 06074
PHONE 860-528 9800
WORK DESCRIPTION: SANITAR I�mCaNCT
f
S
THE DRAIN LAYER ASSIGNED TO THIS PERMIT HAS A VALID LICENSI;TSSUED BY TIIE 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,AT UDSI REQUIREMENTS,ANI 3HE�ITTACHED CONDITIONS.
7
ISSUED BY DATE INSPECTED INSPECTED BY
3/20/2.015 8:59 AM
............. ........ .... ........ ..
W> w
' 4
r
�Y r
S
Wiz.
i4
e
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I 0Q0 CONTRACTOR: �J rpt) rmgj V �
LOCATION: 13 s Su 1l liA n Avenue
TYPE OF WORK: h;3a([.n
DATE INSP NEEDED: DATE INSP: Y117 115—
INSPECTED BY: r
WORK IN
PROGRESS:, von��v, 1 .S' ,�vrrsi�c�. •� S� �
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED klrE'S 0 NO
AS-BUILT:
INPUT: DATE:
S/molloy/forms 2014 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: Lot #
Street No, Street Name
Premises owned by: �
Name of Frm:_,E/�i V,Ll2 �7 L sU&s, r&C Phone: 6�
Address of Firm: �' r�12�d Gt r��— �- �D W 6GL�S��Z C
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water Well
Proposed Start Date 1 Estimated time for completion
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 ���_c lnP l Do v 4-r 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. . 2 -0. ,f 2� IFA SA/YITARYSEWER LATERAL
IS WITHIIir 75 FEET OFA WELL
ITMUSTBEArR TESTED
Signed: Print Name: �2✓��/
Licensed Drain Layer
Date:
standard Forms\Per►niWPPLICATION FOR()RAIN LAYERS PERMU.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: V " 7 20 f
BUILDING ADDRESS : 13
STREET : n A
SUBDIVISION:
NORTH ARROW
_ W I _ k
-------------------
6ijo4A)44,:n4j,1 z fz2- iv,, cp /W<�
CONTRACTOR (PRINT) NAME 0 ONTRAC S SUPERVISOR (PRINT)
STREET ADDRESS Sl NA RE
CS' C�
TOWN STATE ZIP INSPECTED BY TOWN
r.
957
a0 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER