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HomeMy WebLinkAboutDrain Layers Permits 785 Foster Street (2) 1600083 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 11/3 0/201 b f: GIS ID:33600785 FEE: 60.00 MUNIS APPLICATION# 201601754EXPIRATION DATE: 12/30/2016 Jy 4 ems . �s APPLICANTkt `s f* y LOCATION NAME: K&B DIVERSIFIED§ERVICES ILI,C X ADDRESS7F( STER STREET ADDRESS: 42 SOMERS ROAD r Y ; •zTTE� LLS;JASON ENFIELD,CT 060841. T w r r"�$ 'l+dTER ST l4s �� �SbT7 H7WINDSOR,CT 06074 PHONE _ p' WORK DESCRIPTION: NEW SWh f1� C1'rCIN• F ` r r gi THE DRAIN LAYER ASSIGNED TO THISSPEIIT1HS AUA�LI�y3 LIENS ISSUET3`B THI`STATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FOI�I I N IHI AST=ACI�FI?` 01�? IQi �S. L V RK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WTNDSOR STAND ADS,sL©SHA IrE( C7TREMEII ,ADD TIC ATTACHED CONDITIONS. t ,v ISSUED BY DATE SPECTED INSPEC D BY 11/30/2016 1:55 PM ko WL L� Lt l qg- i SRjU} Y x ` ^ r``fitTr �' 3 �S y i� rti s $ s„a4� 1• j (• 1 Eli Ag 2.<- TOWN OF SOUTH WINDSOR INSPECTION REPORT t PERMIT NO:: 16 oye)60- CONTRACTOR: K t ,6 A fie,5 3 J LOCATION: aS_ 5- 15' ee- TYPE OF WORK: A)eW .5-6 u2r 2 C n�,n 2c_'111�►�. DATE INSP NEEDED: DATE INSP. INSPECTED BY: �> WORK IN PROGRESS'hL r SEPTIC TANK PUMPED,SMASHED,FILLED .✓'"1 ItNESSED ❑YES 4"190 AS-BUILT: INPUT: DATE: : S/molloy/forms 2014 Town of South Windsor IMPSECIIOITREPORT 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: / 1 �� L Lot # Street No. Street Name Premises owned by: J�✓ tom Name of Firm: 1)A' 0;U C-P_�; Phone: 03 Address of Firm: 3 c S � e C—L ao 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 i',30 Estimated time for completion e 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 i U r)DIN the holder of Drain Layer's License No. 2_� . 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. ���(0 r / �� /` PLEASE NOTE: IF A SANITARY SEWER LATERAL IS WITHIN 75 FEET OF A WELL IT MUST BE-�AIR `TESTED za- Signed: t Print Name: Licensed Drain Layer Date. I Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMrT,doc Molloy, Catherine From: ca[Icenter@cbyd,com Sent: Wednesday, November 23, 2016 12:14 PM To: CBYD Subject: Locate Request-20164702115 Attachments: 20164702 1 1 5.PDF N' 20164702115.PDF (116 KB) (CALL BEFORE YOU DIG - CT) 11/23/2016 12:12451 -5G -C1 -CW -F5 -GV -OT 4-SW SWINDS -------------------------------------------------------------------------- *** REMOTE BATCH ENTRY *** ***** ROUTINE ***** TIME. .12:12 DATE. .11/23/2016 REQUEST NO. . .20164702115 LATITUDE. .41.841351 LONGITUDE. .-72.534381 TOWN. . . . . .SOUTH WINDSOR ADDRESS. . .785 STREET. . . .FOSTER STREET EXT NEAREST CROSS STREET. .ELLINGTON RD --------------=----------------------------------------------------------- TYPE OF WORK. . . . .DATA/FIBER MAIN INST TRENCHING AREA IS MARKED. . .YES REMARKS: SEWER CONNECTION ------------------------------------------------------------------=------- START DATE. . . . . .11/30/2016 START TIME. .08:00 CALLER. . . . . . . . . .MR KEITH URBON CALL BACK. . . . . . . PHONE #. . . . . . . . .860=749-5001 FAX #. . . . . . . . . . . ALT. PHONE #. . . .860-558-5903 EMAIL ADDRESS. . .KBDIVER81FIED@SBCGLOBAL.NET CONTRACTOR. . . . . .K & B DIVERSIFIED SERVICES ADDRESS. . . . . . . . .32 SOMERS RD CITY. . . . . . . . . .ENFIELD STATE. . . . . . . . . . .CT ZIP. . . . . . . . . . . . .06082 -------------------------------------------------------------------------- EXCAVATOR DOING WORK. .K & B DIVERSIFIED SERVICES ISSUED TO: DATE: TIME: BY: DATE/TIME ARRIVED: TIME LEFT: COMPLETED BY: 1 TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS STREET SUBDIVISION: NORTH A OW 94 71 -IF: I _ — — ol CONTRACTOR (PRINT) NAME 0 CO TRACTOR' ; SUPERVISOR (PRINT) STREET ADDRESS //_ SIGNATURE DATE TOWN STATE ZIP INSPECTED BY TOWN — !� w- c/ S M DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER