HomeMy WebLinkAboutDrain Layers Permits 92 Chaponis Way (2) 1700010 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
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DA
TE: 04/18/201 7
GIS ID: 18270092 FEE: 0.00
MUNIS APPLICATION# 201700379 EXPIRATION DATE: 05/18/2017
APPLICANT' '
LOCATION
NAME: EAGLE EARTHWORK,SERV ADDRESS 92 CH PONIS WAY
ADDRESS: 101 N MOUNTAIN R{OAJ QCINER 1Vi1NNRIN0 BUILDERS LLC
CANTON,CT 06019 r " 4Q0' HA PEL ROAD#3F
SCWTH WINDSOR,CT 06074
PHONE 860-6911,4021 ' 4
WORK DESCRIPTION: NEW SEWEIt,COINTrCTION `
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THE DRAIN LAYER ASSIGNED TO THIS TEWIT kIAS A Vt -CENSE ISSUED$Y HE=STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FOR IH IN THE ElTTA6-HBP`,-a I�IONS"„AI L VV;ORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDAYIpS,ALL OSHA R$QIJITtEMEIfiS�AID THE ATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED BY
4/18/2017 1:55 PM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMTI'NO:: / CONTRACTOR:. /)S�,,►,U
LOCATION:
TYPE OF
DATE INSP NEEDED: DATE INSP:
INSPECTED BY.'-
WORK IN
PROGRESS:
SEPTIC TANK.PUMPED;SMASHED, FILLED WITNESSED ❑YES ❑ NO
INPUT. L Uti� DATE- '
S/moitoylfbrms 2014 Town of South Windsor INPSi^ MWR REPORT 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
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Location of proposed work: 2 �? f`fC `r `� `` Lot # ' `)
Street No. Street Name
Premises owned by. .��{
Name of Firm: Phone
Address of Firm: V
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with er! c
Existing Water Supply: Public Water_ Well
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Proposed Start Date Estimated time for completion ) A/kf
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
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the holder of Drain
Permit is to be issued tol��� �� c ���
Layer's License No. `- '` i 1` 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. PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE AIR TESTED
Signed: Print Name:2N,
Lic "used Drain Layer
Date: il
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET
SUBDIVISION: kkF.�`Y % :r �-
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NORTH ARROW
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CONTRA TOR (PRINT) NAMT 0 CONTRACTOR'S SUPERVISOR (PRINT)
S REET ADDRESS SIOWATME
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17-Cs�`� Ll' �( %' t I �`' � DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER