HomeMy WebLinkAboutDrain Layers Permits 50 Andrews Way (11) 1600002 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 01/06/2016
0,5
GIS ID: 03200050 F ;; FEE: 60,00
MUNIS APPLICATION# 201600016 t„ EXPIRATION DATE: 02/05/2016
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APPLICANT kN k LOCATION
NAME: BUTLER COMPANYi ADDRESS 50 ANDREWS WAY
ADDRESS: 848 MARSHALL PHELP`9 ROAD OWNER SOUTH WINDSOR DEVELOPERS LLC
WINDSOR, CT 0609 2f NfAIN STREET SUITE 100A
g, Cf l,&TlH 1M,NJ 07928
PHONE 860-688'8024 _
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WORK DESCRIPTION: SEWERCOf'EG]If7�T FOR IUILDING 2 TJNITS01 24+ `
THE DRAIN LAYER ASSIGNED TO THISpE1IT HAS A VALID LCETSI ISSUED B5� 1'HE�STATE AND HERESY AGREES TO ALL
THE TERMS AND CONDITIONS SET FOR1H I'N�HE:ATTACIEI� CONDITIONS' IyL ,WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDAI.DS,AL
1 OSHA=REQI7LREMENTS, TI3'1;ATTACHED CONDITIONS.
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ISSUED BY DA E INSPECTED INSPECTED BY
1/6/2016 12:16 PM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.; / 49000 CONTRACTOR: 6LL-fJ�g
LOCATION: Idd oZ (,` cLZ--l-.) 7
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TYPE OF WORK: ky,") s E'ky r C0 0 V-\eo n
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: fib
WORK IN
PROGRESS: L- Pvc- SzrZ 3 S rrim-, smi
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f'�ctiy,�es 6'Z'lst� c�su�S ��-) ocl�-� $✓�rruw� cZ2� 31 C_rv-s'
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO -
AS-BUILT:
INPUT: (,� � DATE: - 1
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S/molloy/forms 2014 Town of South Windsor INPSEC ION REPORT 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVAN-AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL
SOUTH WINDSOR,CT
FEE$60.00
4 —?L 0
Location of proposed work: D W� Lot# ,
Street No. Street Name
Premises owned by: 2LIgge4a.., "k.
Name of Firm: - 7 Phone:
Address of Firm 40G�
TYPE OF WORK:
Lay House Drain ; Repair.House Drain :
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
• Connection will be made with -
B(isting Water Supply: Public Water V
Well
Proposed Start Date Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH.TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA.REQUIREMENve�
NDMONS ATTACHED TO THE PERMIT
--�'
Permit Is to be issu torr40eo,15--4— the holder of Drain
Layer's License No. 7 my holders of P-1, P-7. or W-9 licenses
will be issued a permit. PERMIT WILL EXPIRE THIRTY(30) DAYS AFTER
DATE OF ISSUANCE. The undersigned Drain Layer hereby agrees to all the terns
and conditions set forth in the permit and attached thereto.. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
PLEASE NOTE;
CBYD No. IFA SANITARYSEWER_LATERAL
IS WITIYIIU7$FEET 4FA WELL
i IT MUS EAIR TESTED
Signed: i Print Name: q"47
4used Drain Layer
Date: d G
Stan0ard F'orms\Pern»ts\APPLrcA1ToN FOR DRAIN LAYERS PERMTr doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS �r �� - 2-
STREET
SUBDIVISION: ��
NORTH ARROW
TIT-
12
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CONTRACTOR (PRINT) NAME OF ONTRACTOR'S SUPERVISOR (PRINT) -
STREET ADDRESS// -SIGNATURE /
`�` - ///f All
TOWN / STATE ZIP INSPECTED BY TOWN
y `-gCSLLI DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTfNG ENGINEER / DEVELOPER