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HomeMy WebLinkAboutDrain Layers Permits 150 Nevers Road 1800087 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT o'. DATE: 11/08/2018 �X F GIS ID: 62400150 FEE: 0.00 MUNIS APPLICATION# 201802219 ,'> EXPIRATION DATE: 12/08/2018 e dr, s� APPLICANT Yu k F ;. LOCATION NAME: ENVIRONMENTAL $R ICES ADDRESS >5 NIWERS ROAD ADDRESS: 90 BROOKFEILD S1? 4RAT x i OWI\TEIt H;s SOJ H"DSOR TOWN OF 41 h �I*�EVERS.ROAD SOUTH WINDSOR,thT, '66A,`l'zk, PHONE 860-528n 950'9 S L t WORK DESCRIPTION: TOWN AROMbV8O IEEE NEVV SANITARY C I TEO�TI SI �T0 BATHROOM AT NEVI'XSyROAD t>' RK ' . 01 ^ THE DRAIN LAYER ASSIGNED TO THI<9*vErMIT HAS A� AI,TD' �G1•1SE ISSUED I"TaSTATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FO Ii�T +ATTt�CH ,I7 `CNDITIOITS' tLLL RCE THE V (ORK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDARDS,ALA C3SI A I (IA ME .,: S ATTACHED CONDITIONS. mofto ISSURYBY DATE INSPECTED INSPECTED BY 11/MO18 10:37 AM i i rt r ( Yj, IV V :Vx�f =fig Al r� yrti .wy" r r VN 1� Y i 16 St`� � # �µ � Nt tier fx'r, Sys 4Pr . ' ` � I I k T :VYIIl1DSQRNSpC N (REPORT PERMIT'NO.: CONTRRICTOR: �P �z JSeL i 46 S . LOCATION: f' e'V s l TYPE OF WORK: DATE INSP NEEDED.: DATE INSP: INSPECTED BY: WORK IN. PROGRESS. C� I-�-�� ,',� to '� ,� .� Szb2 3 is t:vi e s �'} IUD✓ ��?+-� r. .4v SEPTIC TANK PUMPtP SMASHED; FILLE©. : WMESSED ❑YES 0 NO' INPUT:_(__f9�'��'` DATE: • ±Lu S/molloy/forms 2o#,4'f=of South Windsor MkkildN REPORT 14 I APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $80.00 Pews Location of proposed work: 50 . NU V t'eS 10 Lot # Street No. Street Dame Premises owned by:—Too rJ 6 r Sc, 0 vQ So/7- C Name of Firm:. 2&, �5n/[j SE Zurc.E z&c Phone& Address of Firm: 1,0 26af, L-4 sO/L TYPE OF WORK: Lay House Drain A6; Repair House Drain ; Sanitary Disconnect Lay Lateral for building with connection_;'or no connection ; Lay Main ,'vevJ.B,-f0 400 A Ate, Lay Lateral for Commercial/Industrial Building number of acres Connection will be made with Existing Water Supply: Public Water Well Proposed Start Date 1 !S ! 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 9 Lc auLA-XA 67A)'/"Z M09 4 the older of Drain Layer's License No. y 7 . Only holders of P-1, 7 or IIU-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. _.,wnd/or ConnDOT Permit No. . CBYD No. 1 O 5� PLEASE NOTE: IF A SANITARY SEWER LATERAL IS WITHIN 75 FEET OF A WELL IT MUST SE.AIR TESTED . Signed: Print Name: Li d Drain Layer l Date: Standard Farm Permits PPLICA7ION FOR DRAIN LAYERS PERMIT REVISION 3/20I8,doc TOWN OF SOUTH WINDSOR . SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: 19 BUILDING ADDRESS STREET : E ' -f- SUBDIVISION: !:R2"P4�&60af NORTH ARROW _#� �-•-�--� E � . i E I � Z t 1 iIs ji _ r i 1100 -- -- --- -T- CONTRACTOR (PRINT) NAME OF CONT TOR'S SUPERVISOR (PRINT) o ° 6� Z L-0 f STREET ADDRESS §IGNATUIff 3 J � ATE TOWN STATE ZIP INSPECTED BY TOWN �D DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER