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HomeMy WebLinkAboutDrain Layers Permits 126 Steep Road (2) 1700052 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 10/03/2017 GIS ID: 85500I26 FEE: 80.00 MUNIS APPLICATION# 201701362 ,r n EXPIRATION DATE: i 1/02/2017 APPLICANT' q LOCATION NAME: JAMES THROWE DMA ADDRESS 126'SA-EP ROAD ADDRESS: 1330 MAIN STREET QWNER I3U11S,tOBERT T&BARBARA E SOUTH WINDSOR, STEEP ROAD 3 SQUTH 4VINDSOR,CT 06074 PHONE 860 289,0 95 x WORK DESCRIPTION: NEW SI�aWEt COsImCTION' T u= THE DRAIN LAYER ASSIGNED TO THIS PEIWI T HAS A ALYI3 LIGEI SE I.SSCIEp$Y TI IE STATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FOR` -l" ,THE:ATTACHED`C4NVI'TT:QNS5' L DRK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDARDS ALL OSHA REQ>JIREMENTS,AND TIDE ATTACHED CONDITIONS. j ISSUED BY DATE INSPECTED INSPECTED BY 10/3/2017 10:47 AM fi > 4 $i U Y v JF mj a y. a q F 164 jr l l; l ti a 1 :s - TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: 0 p©.S �- CONTRACTOR:_X)Alq 5 LOCATION: aCa r`�c.t TYPE OF WORK: rr-� C`ray.�n�rRc�r1 DATE INSP NEEDED: DATE INSP: INSPECTED BY: 9 fi WORK IN PROGRESS: � �. ,- ,��„.ik&149' � "' PAL 'O ,_ . l SEPTIC TANK PUMPED, SMASHED, FILLED !/ WITNESSED [DI�S Ej NO AS-BUILT: INPUT: CAN DATE: 71-1 S/moltoy/forms 2014 Town of South Windsor INPSECRON REPORT 14 APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $80.00 Location of proposed work: / RA Lot # Street No. Street Name Premises owned by: ��bec '� �►'� Name of Firm: �f,'4- C �l,C, Phone:'�,b_2'�;-76c -5 Address of Firm: l 3C) (YIQ i h 54 sol TYPE OF WORK: Lay House Drain ; Repair House Drain ; Lay Lateral for building with connection ; or no connection ; Lay Main Lay Lateral for Commercial/Industrial Building number of acres Connection will be made with Existing Water Supply: Public Water X Well Proposed Start Date Estimated time for completion l 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 lti^-� the holder of Drain Layer's License No. b f . 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 I M� UST BE AIR TESTED Signed: Print Name: #'V�y Licensed Drain Drain Layer Date: s ? Standard Forms\Permits\APPLICATION fOR DRAIN LAYERS PERMIT REVISION 2017.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS STREET : ST E E e SUBDIVISION: NORTH ARROW r` N �� - 4fit CONTRACTOR (PRINT) f NAME E CONTRACT SUPERVISOR (PRINT) STREET ADDRESS SI y TURE L4 _ /4/17 DATE TOWN _- C"' STATE ZIPINSPECTED BY TOWN 3_& 7 zS DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER