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HomeMy WebLinkAboutDrain Layers Permits 36 Lexie Lane 1700031 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT , DATE: 06/22/2017 z r ' GIS ID:53450036 u" k FEE: 0.00 MUNIS APPLICATION# 201700777µ EXPIRATION DATE: 07/22/2017 F APPLICANTv, LOCATION � NAME: T&M BUILDING Cq INC ApDRES �36rI E3IE LANE ADDRESS: 110 BROOK STREET' s BUILDING CO INC TORRINGTON,CT 069'0 , }yFld`Bo OK STREET 1 jli "INa� QXRINUTON,CT 06790 PHONE 860-88 5910= � rt WORK DESCRIPTION: BUILD (r '� LII�T��S NEW SEWER1G�?NNCIICTLRIIT FEE COLLE�` L "O'NA20174©77fl; THE DRAIN LAYER ASSIGNED TO THI sPE, ITSE,*1S�►"�1 7 IC$ S1r ISSL�I ICOBYrTH9STATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FOR`rT� F;tA TtCIIED`C�(I�1D1I018', }Ll�V�ORK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDIiD ,A7 L�OSHAIQU �VIETTS;ADD THE ATTACHED CONDITIONS. ISSUED BY DATE INSPECTED INSPECTED BY 6/22/2017 3:52 PM vOr ��• a t r w l S ° 4 to sK hvk v� Ch t f/rF�tir x w: F TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMTI'NO:: 7 CONTRACTOR.,,._.l LOCATION: TYPE OF.WORK, DATE INSP NEEDED: DATE INSP: 1 INSPECTED BY: WORK IN PROGRESS; ,-; ik v►s' i� C .. /�' 3 I ON SEPTIC-TANK.PUMPED,SMASHED, FILLED_ WITNESSED [:]YES ❑NO AS:BUILT: INPUT: DATE: 7 rvvI WolloyNarms 2014 Tom of 5auth Windsor INRSEMN'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 Location of proposed work: /�,�-20,�y ��f�a �`�' Street No. Street Name ` Premises owned by: l �s Name of Firm: Zc__ Phone: Address of Firm: 3 /n,,,,, 1W C���`s � (f% <06' /GCS TYPE OF WORK: Lay House Drain �� Repair House Drain ; Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with <S'Z/? 3 S" ��c ,r Existing Water Supply: Public Water Well Proposed Start Date Glocll?- Estimated time for completion S' 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 � f�s % 26o c �z the holder of Drain Layer's License No. �Saa� 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 Sign Print Name: C.Cc. 7-Lo, � License Drain L r Date: Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS : Z'� Z 0 �'� �. c U STREET : L-0--t-t— SUBDIVISION: NORTH ARROW _ Nm .000 --� -- ► rrJ �i 4v - a 17,r r Lj- T4L G CONTRACTOR (PRINT) NAME OF C T CTOR' SUPERV (PRINT} STREET ADD ESS S E .01 DATE TOWN � STATE Zip INSPECTED BY TOWN 90 ' J'�7J7' 0 K DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER wr