HomeMy WebLinkAboutDrain Layers Permits 33 Davewell Road 1800083 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 11/06/2018 '
GIS ID:26100033 k 3 _ FEE: 80.00
MUNIS APPLICATION# 201802201 M EXPIRATION DATE: 12/06/2018
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APPLIC ' LOCATION
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NAME: WASTEWATER SER#ICI S/DBA STRIP$ ADDR) )A�lEWELL ROAD
ADDRESS: 21 COURTNEY DRIVE ER'' T) CTS N GARY R&JENNIFER L
33 DAV WELL ROAD
ELLINGTON,CT 06%OZ9 =
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PHONE L
WORK DESCRIPTION: NEW SE
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THE DRAIN LAYER ASSIGNED TO THIS?PEIIIITiHAS A VALID LIG1aAIS1SSUE `$ TH `STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH I`N FTIE ATTtkCID`COSNDIIIOI[S; e7 L 1?ORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDftS,ALL OSHA R1;C TJIRMMEI i`i"S,1 T ATTACHED CONDITIONS.
ISSUE6 BY DATE INSPECTED SPECTED BY
11/6/2018 1 I:47 AM
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TQ1A OF SOUTH:INNbSQR INS 'ECi N REPORT
PERMrr NO.: • 4. 000 9 CONTRACTOR
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TYPE OF WORK: •7iM 2 Gi)eA ('=2& jjl
DATE INSP NEEDED: 1 d401 DACE INSP.—
INSPECTED-BY '
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INPUT• � DATE:
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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: 3 3W Id f I- Lot #
Street No. Street Name
Premises owned by: 6 A7z
Name of Firm: Phone: �o
Address of Firm: 27r Cc --7u C Y C'X_ eJ G 71� r
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 3 5--
Existing Water Supply: Public Water Y� 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 ro7/Lc the holder of Drain
Layer's License No. o 7o,7 -7 z 5 . 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. U r 5 0 P d Z PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST 13E.AIR TESTED .
Signe a4 Print Name: 77yco IrS
Licensed Drain Layer
Date:— a-
Standard Formffermits\APPLICATION FOR DRAIN LAYERS PERMIT REVISION 3/2018.doc
Drabek, Bernard
From: callcenter@cbyd.com
Sent: Tuesday, November 06, 2018 9:00 AM
To: CBYD
Subject: Locate Request -20184501492
Attachments: 20184501492.PDF
(CALL BEFORE YOU DIG-CT) 11/06/2018 08:59:01
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*** REMOTE BATCH ENTRY***
***** ROUTINE*****
TI M E..08:59 DATE..11/06/2018
REQUEST NO...20184501492
LATITUDE..41.815100 LONG ITUDE..-72.593183
TOWN......SOUTH WINDSOR
ADDRESS...33
STREET....DAVEWELL ROAD
NEAREST
CROSS STR E ET..PLEASANT VALLEY
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TYPE OF WORK.....SEWER SVC INSTALL MACHINE EXC
AREA IS MARKED...YES
REMARKS:
CONNECTION HOUSE TO SEWER.FROM BACK OF HOUSE ALONG RIGHT SIDE OF HOUSE
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START DATE......11/12/2018 START TIME..00:01
CALLER..........MR GRADY OLIVER
CALL BACK.......
PHONE#.........860-896-8191
FAX#...........860-871-1587
ALT. PHONE#....860-871-2616
EMAIL ADDRESS...INFO@SKIPSWASTEWATER.COM
CONTRACTOR......SKIPS WASTEWATER SERVICES
ADDRESS.........21 COURTNEY DRIVE
CITY............E LLI NGTO N
STATE...........CT
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
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DATE OF CONSTRUCTION: 1 - X2 -19
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BUILDING ADDRESS _33 aLt, well_rd �i ,kk I,�hct°sor"
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