HomeMy WebLinkAboutDrain Layers Permits 60 Schoolhouse Driv (2) 1900026 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
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DATE: 03/11/2019
GISID: 81200060 '411 -` f FEE: 80.00
MUNIS APPLICATION# 201900378 $ F EXPIRATION DATE: 04/10/2019
LOCATION
APPLICANT ,< y
NAME: EAGLE EARTHWOIV r DDRESS yb'0 SCHOOLHOUSE DRIVE
ADDRESS: 101 N MOUNTAINQDfiINNARINO BUILDERS INC
CIIAPEL ROAD UNIT 3-F
CANTON,CT 06019
PHONE 860-69 20a7z(., 1 y,
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WORK DESCRIPTION: NEW SWRQNECTTON� x �� 1 1
THE DRAIN LAYER ASSIGNED TO THIS PPIT HAS A VALID I.ICErI�1;ISSL� I BY TH1 STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH` THE AmTAC IE�j (�I*1DIT O TS.'fA`I,L,WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR 8TANDpS2�AL1J�7SI3A REQUIREMENTS,� iID THE ATTACHED CONDITIONS.
ISSUED BY 3/11/2019 10:39 AM DATE INSPECTED SPECTED BY
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TOWN OF SQUTM WINbSOR INSPECVION REPORT
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PERMIT NO,: CONTRAGTDR'�
LOCATION: hiLzi—e ILL
TYPE OF WORK: �P.tt� L�n rNe
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DAT INSP NEEDED.• DATE INSP-. LIT-1
INSPECTED
WORK IN
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INPUT: DATE:
S/mclioyfib ms 2K4 Town Of SONi h Windsor INFSd:rLON Pgpbp.T 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: V �� � 11�� �� Lot #
Street No. Street Name
Premises owned by: �Nd
Name of Firm: 1� Phone: 012 a' 5S �
Address of Firm: f �/e�►� �o ��� ���I
TYPE OF WORK:
Lay House Drainling
; Repair House Drain ; Sanitary Disconnect
Lay Lateral for b with connections or no connection,
Lay Main
Lay Lateral for Commercial/Industrial Building number of---acres
t PConnection will be made with
Existing Water Supply: Public Water Well
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Proposed Start Date Z�� Estimated time for completion &,9el
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 too the holder of Drain
Layer's License No. . 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: � Print Name: rG4l die
r la,/!�
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMrr REVISION 3/2018.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 2
BUILDING ADDRESS �a
STREET
SUBDIVISION:
NORTH ARROW
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CONTRAC (PRINT) NAME C NTRACTOR'S SUPERVI OR (PRINT)
STREET ADDRESS SI NATU�
J +C. '�- y �, DATE
TOWN STATE ZIP INSPECTED V, TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER