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HomeMy WebLinkAboutDrain Layers Permits 99996 Andrews Way (2) 1600.035 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT gl DATE: 06/23/2016 GIS ID:03200050 FEE: 60.00 MUNIS APPLICATION# 201600846 ' EXPIRATION DATE: 0 7/2 312 0 1 6 i. APPLICANT 4r LOCATION NAME: BUTLER COMPANY ADDRESS SO"ANDREWS WAY ADDRESS: 848 MARSHALL PI#ET.pS ROAD? O 4NER SOiJTI ;WINDSOR DEVELOPERS LLC WINDSOR,CT 0605 s x 4 2 1VIAIN STREET SUITE 100A 14 M,NJ 07928 PHONE 860-64 $024 a t , WORK DESCRIPTION: NEW SW�I2Q»NECTIOlOMMERIAI BULKING fxTJNITS 601-608 4r THE DRAIN LAYER ASSIGNED TO THIS,PFIF IDS A VALID LLFIr( $ISSLtE B 0H "STATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FORS tI'7N THE ATTICIED`GOIDITIONS' LORK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STAND)ItD5,14LL©SHAREQUIRI;MEl*1TS A]IDfTHE ATTACHED CONDITIONS. x ISSUED BY DATE SPECTED INSPECTED BY 6/23/2016 8:49 AM ----- --- ----- ----- --------.. ----------- ---------- --- -- - ------- k gti M .M ;d �f 1 4 � e e ,r 3 �d i F 4 5 h t R4 t. Zs t TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.; 0. CONTRACTOR:_ Ui ��i� LOCATION: /)av - TYPE OF WORK: l DATE INSP NEEDED: DATE INSP: INSPECTED BY: r WORK IN PPOGRESS:_ AOorAer n. SeVyer 6ern e-J) a j a P ieill- �-41 k4>.-- - -- c Lr velred)tw 1. a x 6- Sg,:jjjjer,,j !5 , ei 3 -0e-4 i eA bet' fi rx 41 , 1 i SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑ YES ❑ NO U-ASB ILT: V �� INPUT: DATE: S/molloy/forms 2014 Town of South Windsor XNPSEMON 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 Na 'Premises owned by:�`�,� � Name of Firm:. ': _yq Jjtf .��� �- c-0 Phone: Address of Firm: TYPE OF WORK: Lay House Drain: Repair House Drain Lay Main --� Lay Lateral for Commercial/Industrial ^.: Building of acres • Connectlon will be made with ::�g Existing Water Supply: Public Water Wei Proposed Start Date = mated dnDe for completion ALL WORK TO BE IN ACCORDANCE Wli7-1.TOWN OF SOUTH WINDSOR STANDARDS, ALL OSHA REQUIREMENTS ANq CONDITIONS ATTACHED TO THE PERMIT Permit is to be issued to �j � � � � the lder of Drain -t := Layer's License.No. . Only holders of P- , �7. �W-9 licenses .,.. will be issued a permit. PERMIT WILL EXPIRE THIRTY( OA- YS 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. } M4` PLEASE NOTE: CBYD No. - f dFA SAN1TARYSPWER-LATERAL IS WJ7'Hr 75FEE7 AFA WELL :.. IT- N(/STE ArR TESrE® Signed: Print Name:' L C n ed Drain Layer Standard Forms\Permits�APPLICA-nON FOR[TRAIN LAYERS PERMIT.dat TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: - I BUILDING ADDRESS _ _ Js w4y Q STREET SUBDIVISION: NORTH ARROW 2s - - I Mom. NKj'f3 o _ _ �� 5o1< CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT) CA STREET ADDRESS SIGNATURE DATE TOWN STATE ZIP INSPECTED BY TOWN DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER