HomeMy WebLinkAboutDrain Layers Permits 40 Deepwood Drive 1700055 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 10/16/2017
GIS ID:27000040 x FEE: 80.00
MUNIS APPLICATION# 201701443 ,< yf EXPIRATION DATE: 11/15/2017
APPLICANT r x, &, LOCATION
NAME: JAMES THROWE DB�� .:, s ADDRESS 40"'DEHPWOOD DRIVE
ADDRESS: 1330 MAIN STREET T ° OWNER HUO>, #LAN J
SOUTH WINDSOR,tOT Q6(t74 4013EPWOOD DRIVE
SOUTH WINDSOR, CT 06074
PHONE 860-28 6045 5
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WORK DESCRIPTION: NEW SI{WEl CONVECTION
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THE DRAIN LAYER ASSIGNED TO TI-IIS4PEFIMIT HQ.S A�ALYD LICENSE ISSL71; BY THE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FOR, IN THExATT�1C.I D°CxQl DITIONS' ALL 6RK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STAND)&D5,AT L OSH, AEQUIIREMENITS�AND iE ATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED BY
10/16/2017 8:24 AM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I o� �� CONTRACTOR:
LOCATION: 10 ,0 414
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TYPE OF WORK:, Pew [
DATE INSP NEEDED: DATE INSP: icy a" 117
INSPECTED BY: fib
WORK IN
PROGRESS:_ ' . ,-
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SEPTIC TANK PUMPED SMASHED FILLED WITNESSED ❑ YES []'NO
AS-BUILT:
INPUT: DATE: '1
S/molloy/forms 2014 Town of South Windsor INPSECTION 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:_ L16 � el j Lot #
Street No. Street Name
Premises owned by:
Name of Firm: ;��,I � �.3 � �' �t� ry�� ka�C;. Phone: �Y 0
� 1-
Address of Firm: ar- ' ' � c� d
TYPE OF WORK:
Lay House Drain X ; 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 s/J/c 3----)-
Existing Water Supply: Public Water X Well
Proposed Start Date l Estimated time for completion / 206
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 J armw's �'-D�XA -' the holder of Drain
Layer's License No. D-(�)1s63� . 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. .2ol PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE AIR TESTED
—�-� m
Signed: Print Na e. �t ro _
Licensed Drain Layer
Date: I C)C;7*/ 7
Standard Forms\Permits\APPLICAIION FOR DRAIN LAYERS PERMIT REVISION 2017.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: zu&oll
BUILDING ADDRESS
STREET : _f -Od b
SUBDIVISION:
NORTH ARROW '
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CONTRACTOR (PRINT) NAME OF CONTRACT O ' SUPERVISOR (PRINT)
133, ) M a�'nL5�°
STREET ADDRESS SIGNORE
So,, des` C 67 i DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK -- CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER