HomeMy WebLinkAboutDrain Layers Permits 38 Schoolhouse Driv 1800085 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 11/06/2018 ='
GIS ID: 81200038
MUNIS APPLICATION# 201802203 F^ K 't k= St z FEE: 80.00
kM EXPIRATION DATE: 12/06/2018
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APPLICAN9 LOCATION
NAME: MANNARINO BUIL1iR5 INC ADDRFS 3$ SCI�OOLHOUSE DRIVE
ADDRESS: 400 CHAPEL ROAD #3 t OSIER 1ANtRINO BUILDERS INC
CHPEL ROAD UNIT 3-F
SOUTH WINDSOR,`C0'bQ74iu ., r x
PHONE 860-289 7D55
WORK DESCRIPTION: NEW SEWEICO1lC
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THE DRAIN LAYER ASSIGNED TO THIS'tPE*l HAS A,VAI.ID I I3✓ NSEaISS[IED`B i'TH STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORT 11V THL AT AC- D`C(j1' I)I I K.-N .,AI�� CORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS ALL OSHt1 I �T]IREMFITS,AND TT�I ATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED BY
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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: S3 �O40d Lot # -
Street No. Street Name
Premises owned by: 0'voov 9t46&"—_r
Name of Firm: �'I� _ rf� � [�I Phone:_Vj p � boo
Address of Firm:-
TYPE OF WORK:
Lay House Drain ; Repair House Drain ; Sanitary Disconnect
Lay Lateral for buil ing with connection ; or no connection
Lay Main
Lay Lateral for Commercial/Industrial Building number of acres
Connection will be made with �j! P y
Existing Water Supply: Public Water— Well
Proposed Start Date �r "- Estimated time for completion P6
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 c41 a-e LW (c� the holder of Drain
Layer's License No. 4--7 . 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. PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE AIR TESTED
Signed: � �/ t Name: ��"644e
Licensed Drain Layer
Date: r! 1
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT REVISION 3/2018.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: I i '-1 —k.
BUILDING ADDRESS
3 � 1
STREET
SUBDIVISION: 5L- boo h.0 0
NORTH ARROW
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CONTRACT'R^(PRINT) NAME OE CONTRACTOR'S SUPERVISOR (PRINT)
StREEf ADDRESS T_ SIG ATURE -
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TOWWN� � t, STATE ZIP INSPECTED BY TOWN-
--a o a-77 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
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