HomeMy WebLinkAboutDrain Layers Permits 50 Andrews Way (3) 1600037 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 06/23/201641
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GIS ID: 03200050 FEE: 60.00
MUNIS APPLICATION# 201600848 s EXPIRATION DATE: 07/23/2016
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APPLICAN�� LOCATION
NAME: BUTLER COMPANY').- ADDRESS 50 ANREWS WAY
ADDRESS: 848 MARSHALL PHELPS 1t0AD OWNEROUTI WINDSOR DEVELOPERS LLC
WINDSOR,CT 060.95 4 261VIAIi STREET SUITE I00A
' iAHAM,N7 07928
PHONE 860-68 $024w F y
WORK DESCRIPTION: NEW S1W1 GQ1NCTIO COMMI�RGAL IL� DINO 7UNITS#701-708
THE DRAIN LAYER ASSIGNED TO THIPF41IT HAS A �1LTp I,IE�FS ISSU3 B` THL(STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH II+ITHE ATT ACHEI7'CON3ITI.:OTST8 4LL CORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS, (L OSHA REQTIIREMENT AIp T $ATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED BY
6/23/2016 8:56 AM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.; Z� 00OS2 CONTRACTOR:
LOCATION: S 0 #q n clr
TYPE OF WORK:_ A)etD LetJeA , rb nneL oll f�
DATE INSP NEEDED: DATE INSP: 3 3c f 7
INSPECTED BY: 67D
WORK IN /
PROGRESS:
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/molloylfnrms 2014 Town of South Wlndsor INPSEMON REPORT 14
APPLICATION FOR DRAIN LAMER 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 Nam
'Premises owned by: L�
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Name of Firm: ' :T
Phone:.
Address ff '
. ess of Firm:
7YPE OF WORK:
Lay House Drain Repair House Drain_
Lay Mainers Lay Lateral for Commercial/Industrial
;: . Building-
Of� acres
• Connection
cfion will be made with
Existing Water Supply: Public Water Well_
Proposed Start Date-1 �,4 maw time for completion
ALL WORK TO BE IN ACCORDANCE WTI'H.TOWN,OF SCf(!TH WINDSOR STANDARDS,
::. ALL OSHA_REQUIREMENTS AN CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to 0Vi ;� ��.�. the holder of Drain
{ ; Layer's License No. 062 7Only holders of P- , -7.�o''V11-9 licenses
will be issued a permit. PERMIT'WILL EXPIRE THIRTY'{ VA'IfS AFT'ER
<` 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.
rz< PLEASE NOTE:
CBYD No. lFA SAIVITARYSEWER,LATERAL
rS W1 TfrN75FE�OFA WELL
rrmusr ASK 1'ES1"E®
Signed:
--� Print
n d Drain Layer
Date:
Standard Fvrms\PermiWPPLICAn0N FOR DRAIN LAYERS PERMIT.&&,
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 3 L3c, 11,7
BUILDING ADDRESS r
STREET
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SUBDIVISION:
NORTH ARROW ✓�
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CONTRACTOR (PRINT) OF NT OR'S PERVISOR (PRINT)
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STREET ADDRESS SIGN
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TOWN STATE ZIP INSP ED Y TOWN
CS
�J OTS DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: /ag
BUILDING ADDRESS r' , �oj -708
STREET
SUBDIVISION:
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NORTH ARROW jVT
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CONTRACTOR (PRINT) AMrOVONT OR' SUPERVISOR (PRINT)
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STREET ADDRESS/ SI RE
A/�Su6 CT R. DATE
To STATE ZIP INSPECT D TOWN
DATE I
TELEPHONE NUMBER'
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WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER