HomeMy WebLinkAboutDrain Layers Permits 75 Longmeadow Drive (2) 1800022 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 04/13/2018
GIS ID: 54670075 FEE: 80.00
MUNIS APPLICATION# 201800452 ,� < EXPIRATION DATE: 05/13/20 i 8
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APPLICANT LOCATION
NAME: SSC CONSTRUCTIOhIsAC ADDR$BS 75 L01 GMEADOW DRIVE
ADDRESS: 1700 SAYBROOK ROAD? cT01L, LAND XVIII LIMITED PARTNERSHIP
MIDDLETOWN,CTlOb457 .50 GIBALTAR ROAD
a y61 - 5 HORSHM,PA 19044
PHONE
WORK DESCRIPTION: NEW S1R C0]�TNECTION
THE DRAIN LAYER ASSIGNED TO THIS�PERMIT HAS A VALID LICENSE ISSUED",BY THIa STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FOR'TI IN THE ATTACIIyD`CONDITIONS' "ALL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,t1T,L3SHAQiIIRt;MEIxITS,ADDF$ATTACHED CONDITIONS.
ISSUED BY DAT INSPECTED INSPECTED BY
4/13/2018 8:23 AM
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TOWN OF SOUTH WINDSOR INSPEC OON REPORT
PERMIT NO.: � wow, �-- CONTRACTOR: � 5 LOCATION.-,- .
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: r�1
WORK IN y t
PROGRESS: �'L9i1 Jl�rb E✓L s �C � l-j!L .5bAl
SEPTIC TANK PUMPED,SMASHED, FILLED W TNESSED ❑YES ❑ NO'
INPUT: / DATE:,
S/molloy/farms 2014 Taws of South Windsor MPSWaON 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: -7s (0MMek JCJL') `ZA. Lot # 1-S
Street No. Street Name
Premises owned by: `��` �3�c�5• ��
Name of Firm: s s�- '�'���-�'G� 1� Phone: 2SG• 2 3
Address of Firm: t-20G
TYPE OF WORK-
Lay House Drain ; Repair House Drain ; Sanitary Disconnect
Lay Lateral for building with connections or no connection ;
Lay Main
Lay Lateral for Commercial/Industrial Building number of acres
Connection will be made with 6 5Qfz--
Existing Water Supply: Public Water Well
Proposed Start Date 41< 13, / 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 s Lky—lc� CcAv---,-�-Cy the holder of Drain
Layer's License No. PLw� yzFf`l �1 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. 201�CS 3 6 I PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE AIR TESTED
i
Signed: Print Name: :iyjec-c ��r��n �►�
Licensed Drain Layer
Date: �1. t 2. rK
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMrT REVISION 3/2018.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 8r. l' Q
BUILDING ADDRESS _—7
STREET
SUBDIVISION: Es �szkos r ;�w�,W,c,�,►�; — .�
NORTH ARROW
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CONTRACTOR (PRINT) �i NAME 0 CONTRACTOR'S SUPERVISOR SPRINT}
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STREET ADDRESS SIGNATURE
!, / `ATE
TOWN STATE ZIP INSPECTED BY TOWN
t.3 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER