HomeMy WebLinkAboutDrain Layers Permits 60 Longmeadow Drive 1800047 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 06/25/2018 ���
GIS ID:54670060 �� �� �s s 'r z FEE: 80.00
MUNIS APPLICATION# 20180105.1 z ' ' r ` T � s EXPIRATION DATE: 07/25/2018
APPLICANTk OCATION
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6NAME: SSC CONSTRUCTION L 0 ONC11�IEADOW DRIVE
ADDRESS: 1700 SAYBROOK ROAD'4 � OWL ` CiL�IV XVIII LIMITED PARTNERSHIP
MIDDLETOWN,CT 067 Gi$RATAR ROAD
VIx'IPA 19044
PHONE lip,
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WORK DESCRIPTION: NEW SEWR1�E}I1NTTIQT
THE DRAIN LAYER ASSIGNED TO THIS PL I S A k1 Ib'I T Ir IrifS.7 77— $1' FBI Tt TE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTITE ATTACKED` I?TTIfJ�IS' WItHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARI3 �A L OIS A REI�iI1T 11+IEI�fTS,ANI TH TIACHED CONDITIONS.
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ISSUED BY DATE SP CTED INSPECTE BY`
6/25/2018 8:38 AM
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TOWN OF SOUTH WINDSOR 1$$PECTION REPORT
PERMIT NO.: . ) CONTRACTOi
LOCATTON:
TYPE OF WORK: W a -d, f�2/212
DATE INSP NEEDED: DATE INSP: d ,�
INSPECTED BY: -sp
WORK IN
PROGRESS:
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ N0
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INPUT: cw . DATE: y
S/Molloy/farms 2014 Town of South 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 $80.00
Location of proposed work: C�� L c)o<)M eo+r)at,) Q)�Z Lot # 36
Street No. Street Name
Premises owned by: �Cb�t (05', 1h L
Name of Firm: 1\C-- Phone: jrb 6. 2 sU .2 3 '
Address of Firm: W( cJ �
TYPE OF WORK-
Lay ; Repair
House Drain , Repair House Drain ; Sanitary Disconnect
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 Z SDN
Existing Water Supply: Public Water � Well
Proposed Start Date 6 2s Estimated time for completion 6 25, l
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 Sat, �^�^ `� the holder of Drain
Layer's License No. PLOA 0ZeTr14(-P7, 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 Z SD SO I PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE AIR TESTED .
Signed: Print Name: S�w�. ��Gr -�• ��
Licensed Drain Layer
Date: G• 2 2, ( K
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT REVISION 3/2018.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 6-6- ' - `s
BUILDING ADDRESS Let 36,
STREET : z `, •���
SUBDIVISION: _ Ae-
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPEI VISOR (PRINT)
I
STRW ADDRESS ,�` - SIGNATURE
! I / K--) /Y°/ C..; [� �f�-''� � DATE
TOWN STATE ZIP INSPECTED BY TOWN SF
DATE
TELEPHONE NUMBER f
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER