HomeMy WebLinkAboutDrain Layers Permits 36 Longmeadow Drive 1800076 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 10/I 6/2018 'r
GIS ID:54670036
MUNIS APPLICATION# 201802030 xs 53`h zx �' y FEE: 80.00
EXPIRATION DATE: 11/15/2018
APPLICANT ' �a L} a •� 'Y �'.; xr�s, '�w t�
NAME: SSC CONSTRUCTIOIfLL� 1 r LOCATION
ADDRESS: 1700 SAYBROOK R(A r 4� �� 36O1MEADOW DRIVE
r, s ti Q R r TL L ND XVIII LIMITED PARTNERSHIP
{JLD RIDGEBURY ROAD
MIDDLETOWN CTD647 T ;ti
PHONE u , Q M ;
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WORK DESCRIPTION: NEW SEVVR `CNh +CTIdIrI `� Y4wz Y '
off � ��4'�``f 4 a sZ.:�4+� �s,� i jx� 3 ��= fL•
THE DRAIN LAYER ASSIGNED TO THIS BERMTXAZ A V. D Ixl t� S$iJ BY4�1r TATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTS III II'A"�'T%TAou'lfj"i ,1 } ,A 4L1 WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDAI S AI T �7S>I PE�VJREftj..4,TS� ATTACHED CONDITIONS.
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DATE INSPECTED
14/16/2418 1:36 PM
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TOWS OF SOUTH.WINDSON 1NSRECTION REPORT
PERMIT NO.: CONT'RACTPR: L� -
LOCATION -ml5vb
TYPE OF WORK: Coo Y ' 1 d
DATE INSP NEEDED DATE INSP:
INSPk..MD By., ` i
WORK IN
PROGAeSS: C
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SEPTIC TANK PUMPEQ,'SMASHED; FILLED wrmESSED ❑'YES [) N0-
AS-BUILT:'
INPUT: DATE: �.., � 4>
5lmoIfay/fom7s a034 Town of south'Whtdsrn+ItpikadN REO*14
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 10, 16- i
BUILDING ADDRESS r[ f L�
STREET �v►� i�'1c°c��� �f +/ —
SUBDIVISION. Ca ��'�'�`� t,J �sC)r—:
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CONTRACTOR (PRINT) NAME O CONTRACTOR'S SUPERVISOR (PRINT)
S'1 U o sc"I f Pucl A tZ d
STREET ADDRESS SI NATURE �,,,
��t..��. ,IGyl e/L DATE
TOWN STATE ZIP INSPECTED BY TOWN
9-6 0, 75o, r?(,:s DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $80.00
Location of proposed work: 3 G f O ql M Lot # � r
Street No. Street Name
Premises owned by: (6< ( <�ems• ✓�G
Name of Firm: Ss� C tr-C—k f c9 r,� ((L Phone: ?6C)• 2 Sd• e. 3 1 3
Address of Firm: (7Ue' 5Y fort,-,Pt- 2J 0�►�J�+�� � �7.
TYPE OF WORK:
Lay House Drain � ; Repair House Drain • Sanitary -
Disconnect
Lay Lateral for building with connection_ or no connection ;
Lay Main
Lay Lateral for Commercial/Industrial Building--L number of acres
Connection will be made with ` sOrl
Existing Water Supply: Public Water well
Proposed Start Date Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit Is to.be.issued to the holder of Drain
Layer's License No. P�P" Ozr7 rk r A"i . Only holders of P-1, P-7 or W-9 licenses
will be Issued a permit. PERMIT WILL EXPIRE THIRTY(30) DAYS AFTER _.
DATE OF ISSUANCE. The undersigned Drain Layer hereby agrees to all the terms
and conditions set forth in the permit and attached thereto. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No. Zo f$'4-20 I PLEASE NOTE:IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE.AIR TESTED .
Signed: rint Name: t�� �-
Licensed Drain Layer
Date:
Standard Fbrms\Permifs\APPLIG4TION FOR DRAIN LAYERS PERMIT REVISION 3/2018.doc