Loading...
HomeMy WebLinkAboutDrain Layers Permits 88 Lexie Lane 1800026 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 05/01/2018 GIS ID: 53450088 5 4 4 FEE: 80.00 MUNIS APPLICATION# 201800578 5 ` "� �� EXPIRATION DATE: 05/31/2018 4 APPLICANTLOCATION NAME: ATLANTIC EXCAVA I N Ir1 t�DDRE 8 E IE LANE ADDRESS: 363 PARUM ROAD w, OWNER $UILDING CO INC COLCHESTER,CTG4,I3 .; l 0 BRQOK STREET ag TD131GTON,CT 06790 PHONE .1 s f 4 WORK DESCRIPTION: NEW SIWL 'I'll , OR BUII,DIN 2 Il; A IE 88 86 84" 2" �a ` ' s`' t �` 'r' THE DRAIN LAYER ASSIGNED TO THI§i $,R bIIT�iAS A VALTI�>1I EN IJ ISSUED�$Y�T HI STATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FOR II�IN TH&KFEKCr 1,C�N171` ONS' ,ALLIWORK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHl IECIIRI MENTS,ANC THE ATTACHED CONDITIONS. ISSUED BY Q DATE INSPECTED INSPECTED BY 5/1/2018 2:09 PM for mart t lj �. 4 ,Z♦' ti . 43 sY 4 v TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: I CONTRACTOR: LOCATION: y' TYPE OF WORK: DATE INSP NEEDED: DATE INSP: INSPECTED BY: WORK IN PROGRESS: t-, l^ s i7 b -5'L' New `Ll / c'I .SW S,& . SEPTIC TANK PUMP D,SMASHED, FILLED WITNESSED ❑YES ❑ NO AS-BUILT: INPUT: - DATE: I i S/molloy(forms 2014 Town of South Wlndsor INPSEMON REPOU 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: 'T-9 W, BY M?fix.r 4.Lot # Street No. Street !Name v Premises owned by: ��;1� / Name of Firm: Phone: 'R-a Address of Firm: 3C3 �ker ?d2 CQ/.�,7Z,, CZ- TYPE OF WORK: Lay House Drain 4- ; 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 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 e5 `7 ec AFam.,. the holder of Drain Layer's License No. <neoys� ,R7 Only holders of P-11 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. . ���'��a 33�? PLEASE NOTE: IF A SANITARY SEWER LATERAL IS WITHIN 75 FEET OF A WELL IT MUST BE AIR TESTED Signe Print Name: � .� 7 pcocv Licensed Dr I Layer Date: i Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT REVISION 2017,doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: 5�z�I BUILDING ADDRESS tgl 26 , . sz STREET SUBDIVISION: S©�� NORTH ARROW L-mc- CONTRACTOR _ m (PRINT) / NAME OF CO R'S S PERVISOR (PRINT) -k-,3 Vr Z- STRE6T ADDRESS /� SIGNATURE fi5 TOWN STATE ZIP INSPECTED BY TOWN 2l6 DATE cqi .,.. TELE HONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER