HomeMy WebLinkAboutDrain Layers Permits 46 Lexie Lane 1700073 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 12/07/2017
GIS ID: 53450046 FEE: 0.00
MUNIS APPLICATION# 201701756 EXPIRATION DATE: 01/06/2018
APPLICANT LOCATION
NAME: ATLANTIC EXCAVATION INC ADDRESS: 46`LEXII,LANE
ADDRESS: 363 PARUM ROAD OWNER . T&..M BUILDING CO INC
COLCHESTER,CT 06415 I10 BROOK STREET
TORRINGTON,CT 06790
PHONE
WORK DESCRIPTION: NEW SEWER CONNECTION BUTL'DING 22 PBRIVIIT FEE COLLECTED
ON APPLICATION 201701755
THE DRAIN LAYER ASSIGNED TO THIS PERMIT HAS A'U•ALID LICENSE ISSUED BY.THE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH"IN THE ATTACHED`CONDITIONS'.,Ai L WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,AL L OSHA REQUIREMENTS,AND THE ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
12/7/2017 10:31 AM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
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PERMIT NO.: 1 ` CONTRACTOR: 7�l
LOCATION: a imp j6ul,-1,- 1La
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP.'.
INSPECTED BY: gs�
WORK IN
PROGRESS: 6 P v 10 YL -S AN b 404 .4`R
glaA
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES . [] NO
AS-BUILT: '
INPUT: DATE: 14 ` t Y "17
S/molloy/forms 2014 Town of Sou(h Windsor INPSEMON REPORT 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT ...
FEE $fAM. 60,
Zirk,c
Location of proposed work S'�?'yl.';<Sa� Sg�G.� ��� Lot # .� �
Street No. Street Name
Premises owned by: / f�l e
Name of Firm: ,, ��• ��`� 3Pc^ctu�"T•,1l_2�e, Phone: �6c� - y/✓ '
Address of Firm:_ ��' ^�tm,,t AC(f/Z-1e,
TYPE OF WORK:
Lay House Drain �;~Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Supply:Water Su I : Public Water Well
Proposed Start Date /2 7 /7 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 _Z�c_ 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. o�O�� Jj� �f'S/ PLEASE NOTE:
IF A.SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE AIR TESTED
Sign Print Name: cs
Licensed Dra' aver
Date:��G
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS z 'S�' �` -
STREET :
SUBDIVISION: 11IO&C
NORTH ARRo
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40
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CONTRACTOR (PRINT) NAM OF R'S SUPERVISOR (PRINT)
STREET ADDRESS shdnk
DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
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TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
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