HomeMy WebLinkAboutDrain Layers Permits 918 Foster Street 1800033 TOWN OF SOUTH WINDSOR, CT
PENT NUMBER DRAIN LAYER PERMIT
DATE: 05/16/2018 k
GIS ID:33600918 4
MUNIS APPLICATION# 201800712 t' 4n FEE: 80.00
€ `y EXPIRATION DATE:
06/15/2018
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APPLICANT s fiA 4 4ry
Y LOCATION
NAME: EAGLE EARTHWOI a R' A�DRE S �y9f B FOSTER S~
ADDRESS: 101 N MOUNTAIN TOA j (�VStN>,Tt MA _ ARINO BUILDERS INC
CANTON,CT 060I 9 € �
Q0 CHAPEL ROAD#3F
�� SQiJH WINDSOR, CT 06074
PHONE 860-693 202.7 f x
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WORK DESCRIPTION: c NEW S]�� �CONN�CTTOIV - r f 7
THE DRAIN LAYER ASSIGNED TO THIS EMMIT6HAS A UA ID LICENSE ISSIJ>p BI��THI;`STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FO "I' li ITE ATFgCI ED`r p1�1DI GINS' AFL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDADS,Al bSHA Ii$(�Ulg12EM1yTT St r4I�1D T. ) ATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED BY
5/I6/2018 2:52 PM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
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PERMIT NO.: - f_ . egUOs CONTRACTOR: � .
LOCATION: —
TYPE OF WORK: _S> a
DATE INSP NEEDED: DATE INSP:
INSPECTED EY: @9
WORK IN
PROGRESS: �c 1�� c���.'. ,�:�> 4 C /�'y`' -So..
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SEPTIC TANK PUMPED,SM F SHED, FILLED—_,--WITNESSED DYES ❑ N®
AS-BUILT:
INPUT: DATE:
S/Molloy/fauns 2014 Town of South Windsor INPSECFTON REPORT 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: f � .r�L IEL --c(A Lot #
Street No. Street Name
Premises owned by: M4hi1'1 n'r412
Name of Firm: r *d�, 0 r,--/C Phone: ��®., 93 'l�'7
Address of Firm: k)o r IX. ti O 1
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ay Lateral for Commercial/Industrial
Building of acres
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Connection will be made with
Existing Water Supply: Public Water Well
Proposed Start Date TQ 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 &,C11n : t&OL, the holder of Drain
Layer's License No. a 7f 11 ` . 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.
i
Signed: Print Name:
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: '�- 72 9-
BUILDING ADDRESS � -
STREET C'7�-a
SUBDIVISION: l,t oC
NORTH ARROW
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CONTRAC R (PRINT) NAME ONTRACTOR'S SUPERVISOR (PRINT)
STR ADDRESS SIG TUBE
SATE
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TOWN STATE ZIP INSPECTED BY TOWN
,eCc) 47.3 `off' DATE
TELEPHONE NUMBER
WHITE - TOWN PINK -- CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER