HomeMy WebLinkAboutDrain Layers Permits 35 Chaponis Way (2) 1700001 TOWN OF SOUTH WINDSOR, CT
PERMITNUMBER ----...___. DRAIN LAYER PERMIT
DATE: 01/03/2017
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GIS ID: 18270035 .;. FEE: 60.00
MUNIS APPLICATION# 201500121 r v EXPIRATION DATE: 02/02/2017
APPLICANT �� LOCATION
NAME: EAGLE EARTHWOR SERV• ADDRESS 3 CH1-PONIS WAY
ADDRESS: 101 N MOUNTAIN RsOAD �iiOWNER 1QNNRINO BUILDERS LLC
CANTON,CT 06019 4QOrCPEL ROAD#3F
SOUTH WINDSOR,CT 06074
PHONE 860-693 202�7
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WORK DESCRIPTION: NEW SFWTIt CQNNECTIC?N '
THE DRAIN LAYER ASSIGNED TO TH �PEIyIII BIAS t V �ID LIGIaNSE�SSUEDBIiSTATE AND HEREBY AGREES TO ALL
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THE TERMS AND CONDITIONS SET FOR`I'?�i.IN TI#E;.A��t��HED CONDITION L WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDDS,Q1_.L OSHA RE�UfEI S,A1D TI3'E ATTACHED CONDITIONS.AR
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ISSUED BY DATE INSPECTED INSPECTED BY
1/3/2017 10:42 AM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:_/ Pao l CONTRACTOR: f P
LOCATION: J5 ao
TYPE OF WORK: Mlew Sa i,3__e-, �)vve o ri
DATE INSP NEEDED: DATE INSP: i.Z 1
INSPECTED BY: 30
WORK IN
PROGRESS: (OV
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SEPTIC TANK PUMPED, ASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
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: CC `
of #
Street No. Street Name
Premises owned by: Mag�q >` � e
Name of Firm:
� Phane:
Address.of Firm:
_TYPE OF WORK:
Lay House Drain; Repair House Drain
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Lay Main; Lay L-ateraf for Commercial/Industrial
Building of acres
Connection will be made with RIC/
Existing Water Supply: Public Water Well
Proposed Start Date 7 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 el( Gee C the holder of Drain
Layer's License No. Only holden o 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
l 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: Print Name: belwt
icensed Drain Layer
Date::
standard Forms\Permits\APPLICA" ON FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 7, l6/'
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STREET : `f "
SUBDIVISION: Cklic.
NORTH ARROW
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STREET ADDRESS SIGNAITRr
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TbK STATE ZIP INSPECTED BY TOWN
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TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER