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HomeMy WebLinkAboutDrain Layers Permits 36 Mountain Drive i 1700070 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 11/30/2017 iA GIS ID:60900036 4 FEE: 80.00 MUNIS APPLICATION# 201701707 .;y r z EXPIRATION DATE: 12/30/2017 APPLICANTS' LOCATION NAME: ADB CONSTRUCTIQl�]8 lavlSEPTIC CORP F ADDRESS6'IGIONTAIN DRIVE ADDRESS: 77 A WOODLAND STR.ET OWNER BOtK]4�JACQUELYN L&JOEL G MANCHESTER,CT06042': 36 MOUNTAIN DRIVE ' 56IJ 1 I WINDSOR,CT 06074 wF PHONE 860 667�45 it WORK DESCRIPTION: NEWtg S$WE C�NNICTION ;� THE DRAIN LAYER ASSIGNED TO THIS�ERIIT HAS A VAT,ID I,fG>I�ISE ISSUED BY TIIIYSTATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FORT'4I M 1HE e9.W' HED CQNDITIQ IS' Alai WORK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDA23S,A1 L• OSHA REQUIREMENTS,AND TIC ATTACHED CONDITIONS. �1 ISSUED BY DATE INSPECTED INSPECTED BY 1 1/30/201 7 8:45 AM a ,� rM1. y y r•c 4 f S : s n E ot y i TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: CONTRACTOR: �,6 co yg.S-fr-. LOCATION: t� DJ � 1 f-, ^ w TYPE OF WORK: DATE INSP NEEDED: DATE INSP: INSPECTED BY: 130 WORK IN PROGRESS: L/L S;, a. 3 - /, '�,,. rr_c�ri �eya-,n_ �'� �s� -rZ ��✓rv"aced SEPTIC TANK PUMPED, SMASHED, FILLED +/ WITNESSED DES El NO AS-BUILT: INPUT:. E M DATE: S/molloy/forms 2014 Town of South Windsor INPSEGTION 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: �{ � �r� Lot # Street No. Street Name Premises owned by:._.. �� - U0 I Lc�,r- Name of Firm: 4",12 6e—i Phone: Address of Firm: ;�-,5, "-s G 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 js We- t�v& Existing Water Supply: Public Water�� Well Proposed Start Date Estimated time for completion 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 A� the holder of Drain Layer's License No. 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. Ou, 7 `&c,S�,00 PLEASE NOTE: IF A SANITARY SEWER LATERAL IS WITHIN 75 FEET OF A WELL IT MUST BE AIR TESTED Signed: 1 Print Name: A-, ,V T� Licensed Drain Layer Date: 1 1 1 8?// .) Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT REVISION 2017.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: -c,. BUILDING ADDRESS STREET SUBDIVISION: NORTH ARROW{ J.__ 44 ► i I E _--. 4. _ i-- I --- —i.—.L___._..�-----i __._�__ 97��3 C�,r+S�"ry��i-•oars Jas�ds i+�r'�aaa CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT) STREET ADDRESS NATURE ` . - - '�1-- DATE an c TOWN STATE ZIP INSPECTED BY TOWN �6g•b�7-as?g DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER ••_ . • - -' -.- ,,j, °°o�. . . � /-I� �'� � 1. ! / 1! 1//A/ MARI£k RE/C4E .6 d LAT., 0 STA. Z -4 5.3 Q�`y�, ! Y y J •v Z9.0 LONG �. 6.3 i DEEP POST, w NIF W/ UR S. PHYLLIS M. ate / MANN• DRI E A, _ 154.a2 � SHE 5J'' _—. — — Y �—�_._.—...._ —— _ •—.. , 4D C.R .T1i© IT. CORE h 0 SN \ \ W Co. 4 W IT. CURBw y`r- 966 L 5TA. 3+ 20.0 �� 9 32.0I LOp MOCKS 1 �/� cV o # 1 �a co+0 Iz 7 w W 1 C.O STOP SIGN --_ — _ —-- --