HomeMy WebLinkAboutDrain Layers Permits 81 Longmeadow Drive 1900021 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 02/22/2019
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GIS ID: 54670081 FEE: $0.00
MUNIS APPLICATION# 201900316 f ' EXPIRATION DATE: 03/24/2019
APPLICAI�IT LOCATION
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NAME: SSC CONSTRUCTIQ.i LLC ApDR S 81 LO TGMEADOW DRIVE
ADDRESS: 1700 SAYBROOK ROAD ' flWTE1� QIt ) AND XVIII LIMITED PARTNERSHIP
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42 OLD:RIDGEBURY ROAD
MIDDLETOWN, CT 064`5� a
PHONE
WORK DESCRIPTION: NEW SFVR CtIi1�1FiCTIO1V
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THE DRAIN LAYER ASSIGNED TO THIS P$RMIT YIAS A V'ALID,LICEISI ISSLTFD B irTI STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH'1N TIDE ATTACHED`C4}NDI I.O�iS "'AIL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSQR STANDAEDS� I{QST3A:RE�IIII�EMENIS,AID TIIEATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED BY
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PERMIT NO.: CONTRACTOR: SSC-
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TYPE OF WORK
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S/moltap/famis own 2014 T of SOUth Windsor.MpS N lepbRT 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: � n�t�ccQo� Lot #
Street No. Street Name
Premises owned by: Tv\
Name of Firm: 07L CcnsFr����� l t C_._ Phone:
Address of Firm: {70C3 �'Q• hfvu� 2� � '� �`""'� ��
TYPE OF WORK::
Lay House Drain �1 ; 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 D r .50't
Existing PP Water Supply: Public Water Well
Proposed Start Date -2• 7 r 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 (r^-"-12 the holder of Drain
Layer's License No. Pl^. OZ r7S'gf'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. Zd "°lD f'00'1:'-) PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE AIR TESTED .
Signed: Print Name:
Licensed Drain Layer
Date: 2• t, l
Standard Farms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT REVISION 3/20i&doc
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) _ NAME OF CONTRACTOR'S, SUPE VISOR (PRINT)
STREET ADDRESS SI NATURE
J ®�' DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER