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HomeMy WebLinkAboutDrain Layers Permits 53 Chaponis Way (2) 1600067 TOWN OF SOUTH WINDSOR CT PERMIT NUMBER r*7 DRAIN LAYER PERMIT DATE: 11/14/2016 �} GIS ID: 18270053 ZF �� 1 C t� MUNIS APPLICATION# 201601676 ,sa �L yr } FEE: 60.00 ;a h 5t EXPIRATION DATE: 12/14/2016 APPLICA 5; NT' Sy 5 k p �2 LOCATION NAME: EAGLE EARTHWO*j,SER t L --- ADDRESS: 101 N MOUNTAIN I1,0-AM. 'y t F ADDRESS S CPL4PONIS WAY CANTON, CT 0601F 7 A� fi,i O; R' �" lt?ANN°iRINO BUILDERS LLC 4F�O IAPEL ROAD#3F PHONE 860-69 2027 a : U�'IWINDSOR, CT 06074 z WORK DESCRIPTION: NE W Ott THE DRAIN LAYER ASSIGNED TO THI PE HAS A mm— E S ISSI lE3 B t I E STATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FORTEI<IN THE A�TAHED`C� 1DTIOIS'. L L WORK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDS OR STANDA1tDS,; I kQSHq A1D�TkFE ATTACHED CONDITIONS. r V t n 4':r b t: r j iiK l 4.5 ISSUED BY DATE INSPECTED. 1 1/14/201 6 2:05PM INNSPECT D BY f ---------------------- is v �A ! N fiX 9 pa b 4 Q ov'O s ( R 2 y 5.� 1 i�91 A 4=prhTy`JiY S�S..0 TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO:: CONTRACT©R: C LOCATION; TYPE OF WORK: DATE INSP NEEDED: DATE INSP: + I INSPECTED WORK IN PROGRESS. 4 �4 L "ir TOM, SEPTIC TANK PUMPED,-SMA8H9D, FILLED WITNESSED ❑YES ❑NO AS-BUILT: i INPUT. DATE• S/molloy/rorms 2014 Town of South Windsor INPSECCION REPORT 14 APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $60.00 Location of proposed work:—!-3 C40 � of # Street No. Street Name . Pr hohn4r,76- emises owned by. Name of Firm: - 4 Phone: Address of Firm: 0 plor-,4 �. y, �6-0 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----? Estimated time for completion ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS, ALL OSHA REQUIREMENTS AND CONDITIONS TTACHED TO THE PERMIT Permit is to be issued to c4a t 14 the holder of Drain Layer's License No. - 1 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. Signed: 11;�*�IKJ411 Print Name: Licensed Drain Layer Date: s 6 standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: 11-1 BUILDING ADDRESS STREET . o4coon'('e wot Z. SUBDIVISION: 1111,drItf 1�,204 ks lt�_' NORTH ARROW _--�------ - I--- - --- -�___..__ _ . __ _._ _- �- _ __-.-__ _-- -- __. _..JL 1 I I I i I r l I F r I 3 i I CONTRA (PR N ) AM CONTRACTOR'S SUPERVISOR (PRINT) STREET ADDRES IG E LIT �� f! DATE T STATE ZIP INSPECTED TOWN 1_6 DATE TELEPHONE NUMBER i WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER