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HomeMy WebLinkAboutDrain Layers Permits 93 Longmeadow Drive (2) 1900019 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT �4 DATE: 02/19/2019 GIS ID:54670093 FEE: 80.00 MUNIS APPLICATION# 201900289 EXPIRATION DATE: 03/21/2019 � h{ wl, d ^�• r APPLICANT :r LOCATION NAME: SSC CONSTRUCTK N LLG` 4 ADDRESS 93`�T.O TGMEADOW DRIVE ADDRESS: 1700 SAYBROOK N'0 D OWNER OI SAND XVIII LIMITED PARTNERSHIP 10LURIDGEBURY ROAD MIDDLETOWN,CT gfi45 ss T PHONE —31 WORK DESCRIPTION: NEW SWI COTNCTIOIV `� r wcv1��P r l THE DRAIN LAYER ASSIGNED TO THt9�PIt IIT HAS A VALID LICE:..... SSUIID;:BY�Tk STATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FORS ITIN THE ATTACHED ONDITIQNS ` I,L U ORK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STAND EIRD'S,A-i-L NT,;AIt1D� ATTACHED CONDITIONS. G00110r.v� ISSUED B DATE INSPECTED INSPECTED BY 2/19/2019 11:04 AM N v t R 7 x •Nr !+f \r :r t � � 6•l.fE' � ,V .1'v� 4 x�' a '1 , �y t5 6-18 �f RK 7. TOWN OF SOUTHWNbS+DRINSPECTION REPORT PERMIT NO.: CONTRACTOR: LOCATION: /V TYPE OF WORK: DATE INSP NEEDED: DATE INSP: INSPECTED BYL_i!L WO IN PROGRESS: :Irk ✓ ;LL , �f ••f c�t . S � 5 r"✓c.9 lyr ;J,1 i;��-j .'�y. If'LJ�v4"! f. ' C..O a�yrµ.� �"� V�.Ci:..4�'• Gl;Jrin.� . Pti1` f 1LS 4R ., � y'actif^f�� SIGH. ` �iTy1N l'l r..� 1 � �(;hy-•. � Jcvi.�l i�'t.....CS-�.�1'`� Z�� ,p c S en_"' SEPTIC TANK PUMPED,'SMASHED; FILLED WITNESSED ❑ 0 NO AS-BUILT INPUT: M- DATE: • S/molloymnTis Zai4 Town of South W idscr mIsS N Ii PORT 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: lend v1/lecrc.Qdr,,1 1Ne. Lot # Street No. Street Name Premises owned by: `Co Q far• TO C Name of Firm: CSC �nsfir��'��an \1L Phone: �6a• 2f�.z 3 Address of Firm: 5k �/cam �2r� ����1`�-�-�-� G7• 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 S�'2 Existing Water Supply: Public Water Well Proposed Start Date 2, 1 /9 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 Sir s — 6c,&,-11, t<n the holder of Drain Layer's License No. P6m- 02�-? W-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. �o i°I©�'pD�S3 PLEASE NOTE: IF A SANITARY SEWER LATERAL IS WITHIN 75 FEET OF A WELL IT MUST BE AIR TESTED Signed: Print Name: Sccua�� �• �' Licensed Drain Layer Date: Z, t ct. Standard Farms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT REVISION 3/2016,doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: - BUILDING ADDRESS STREET SUBDIVISION: NORTH ARROW oo 1 y _,�� CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT) STREET ADDRESS SIGNATURE fI s-! ii �� ! f � ...�� f�..•- ... #/ ATE if TOWN STATE ZIP INSPECTED BY TOWN DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW -- CONSULTING ENGINEER / DEVELOPER