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HomeMy WebLinkAboutDrain Layers Permits 9999 Schoolhouse Dr 1800056 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 07/31/2018 , GIS ID: 81209999 tfa `" *� FEE: 80.00 MUNIS APPLICATION# 201801361 "��tij�� �. EXPIRATION DATE: 08/30/2018 AR APPLICAN LOCATION NAME: EAGLE EARTHWO RV� j 14 x,ADDRES ' }909'SQHOOLHOUSE DRIVE ADDRESS: I01 N MOUNTAIN R MANNA4RIN0 BUILDERS INC r } r � � H&EL RD UNIT 3-F CANTON,CT 060191 AWE F PHONE 860-693 Q027. s A '�' t 4• 4` r .,t sit s. #�iur's 4g' WORK DESCRIPTION: LAY SE�P1`1 FOROH�OO IOTSE}:DR) �� " ` THE DRAIN LAYER ASSIGNED TO THI§%RM E AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS 5ET FORT IN T4I AT,TALH 1 ;C iN13I�T O Sx°r�AI I RK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDAIpSs� LI�EQ,iIRI✓MEI�IT$SANS TI ATTACHED CONDITIONS. ISSUED BY DATE INSPECTED INSPECTED BY 8/1/2018 8:32'AM go -x. 4 .:n § Alt v'' MIR5 fi X y TOWN OF SOUTH WINDSOR'EMSPEC71ON REPORT PERMIT NO.: docoS C®NTRACTOR:,!;_:' k &avqAYZZZ LOCATION: �1°Icl TYPE OF WORK: Laid Q =I I __;ve- DATE INSP NEEDED.- V DATE INSP:_ io%`?l%g INSPECTED WORK IN PROGRESS: .1 ,A_i O,r F ,n e . . SE IC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑ NO AS-BUILT: INPUT:, _LW DATE: I o�A S/molloy/forms 2M4 Tbvm of South Windsor.INPS9dndN 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: 00 ��©U5� Lot # Street No. Street Name Premises owned by: L IA- Name of Firm: Phone: �'(od�C��'� c��-7 Address of Firm: 67 0 +6 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 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 /e'0� Permit is to be issued to 1�6�C�ad lr4'4 the holder of Drain Layer's License No. 37 F77 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. l 173 � CBYD No. �-U I PLEASE NOTE: IF A SANITARY SEWER LATERAL IS WITHIN 75 FEET OF A WELL z IT MUST BE AIR TESTED Si ned. ff Print Name: A�440-l LzLe Licensed Drain Layer Date: ' 24 l Standard FormsTermiWPPUCATION FOR DRAIN LAYERS PERMIT REVISION 3/2018.doc i i TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: �. BUILDING ADDRESS : . :Z4 2 5 3 Z 17 35 STREET �ouse. V6 SUBDIVISION: blnvt, NORTH ARROW Iq _4_ 1ZQ 1110 ! CONTRACTOR (PRINT) NAME 0 e CONT C ORS S ERVISOR (PRINT) STREET ADDRESS SIGNATURE 0 _�_C b — �a� �. - 1��z ATE TOWN TATE ZIP INSPECTED BY TOWN RW L91 -20:2-7 DATE TELEPHONE NUMBER WHITE — TOWN PINK — CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER i TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: Auaos� 2) BUILDING ADDRESS STREET 4b LaseL)/'k Uto-, SUBDIVISION: ao U3 15 {f NORTH ARROW I I 1.0 1 II k ........ CONTRACTOR (PRINT) NAME OF CONT CTOR'S ScP RVISOR (PRINT) o4aid 17-3o- --?(A 5 ST EET ADDRESS SIGNATURE 6� ® d ® IS TOWN Q STATE ZIP INSPECTED BY TOWN (d 20 �.. DATE 26 -6q,3 TELEPHONE NUMBER 3 WHITE - TOWN PINKCONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER i TOWN OF SOUTH WINDSOR SANITARY_ SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: AU_(sczS - BUILDING ADDRESS : Ib 'Sc9co� C)dse Dgtlle STREET : S l " 13 SUBDIVISION: SCP, 06L HD I ye NORTH ARROW SJU..... _ _.._ ,..._.. .....-.... .._ ..�E f _.. ........ ._.. CONTRACTOR (PRINT) ANAEaCINTOR'S SUPERVISOR (PRINT) � � •_Loll ST EET ADDRESS SIGNATURE DATE TOWN /� / STATE ZIP INSPECTED BY TOWN (DJ) l p s-2-D 1-? DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: ( 5- BUILDING ADDRESS S7 STREET LLD yS.F-7 J-)A / SUBDIVISION: I Vj� NORTH AR OW Wo A K CONTRACTOR (PRINT) NAME OF CONTRACTORS SUP RVISOR (PRINT) r ® h - v-2vra STREET A DRESS SIGNA URE TOWN STATE ZIP INSPECTED BY TOWN DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER