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HomeMy WebLinkAboutDrain Layers Permits 57 Longmeadow Drive (2) 1900039 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 04/04/2019 GIS ID: 54670057 FEE: 80.00 MUNIS APPLICATION# 201900578 do `rti, EXPIRATION DATE: 05/04/2019 y >> t;, APPLICANnT N x LOCATION NAME: SSC CONSTRUCTION 10 r z ADDR>;SS 5'�LO GMEADOW DRIVE ADDRESS: 1700 SAYBROOK R f 'r OTTER i TQ�.I )SAND XVIII LIMITED PARTNERSHIP 3 3 r700 MIT DLETOWN AVE �,Ja r i4 MIDDLETOWN,Cfi 064SZ' r PHONE i f �� f s tl r r ' ♦; Ir 1 R v WORK DESCRIPTION: NEW SW1�IbTE,CTION f s i' t ..' i ;•; THE DRAIN LAYER ASSIGNED TO THIS'+PE TIT HAS A VAT,ID LTC'EN9.., ISSL11yY3 B T'STH.E STATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FOR�TII INyTHE4TTACI3ED`C4iDfTION'S', ALL WORK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDASAI I O6IA'RE+Q{TIR�IV�ENT S,11NDI E ATTACHED CONDITIONS. V y AID ` ISSUED BY JAMNSPECTED INSPECTED 4/4/2019 1:20 PM • I i i ' 4 [ e !A by is 4 h J qFJ r > NON 5 � Y Y 1 J ll f V f9 J 1 i 1 Gtt'rEf � a V Z 11 F •'r y'12 '' ,.., .. t i TOWN OF SQUTN.IN�NRINSPEC�N REPORT PERMIT NO.: l �D!?,5 cf CONTRAGTQR. 5SCi LOCATION: 44 1 TYPE OF WORK: DATE INSP: DATE INSP NEEDED' - /9 INSPECTED-BY: wordow PROGRESS: ����F� � �� �;�� �.��•' • • - 7A SEPTIC TANK PUMPED,SMASHED;FILLED-- - wrmESSED ❑-YES C] NO' AS-BUILT DATE: i1QN IC PORT 14 S/moHfoy/ n=7D14 TOVM of Sculh Windsor mpPs 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:_ 5 7 lm, fieaWUtv Lot # 3 Street No. Street Name Premises owned by: C Name of Firm: S°S`C Phone: c). 25a 31 Address of Firm: 10 M.V(-)12- wr7 L7 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 6 S�►'Z Existing Water Supply: Public Water Well Proposed Start Date 1'{` 4, c9 Estimated time for completion L���/. I 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 5c i _Gu' fvl k 11 1 the holder of Drain Layer's License No. -hm ©Z(Y7r411-07. 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. C)Q 6 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: LC t t�. 1 Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT REVISION 3/2018.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS f STREET : L D rneCLitA) i-v��-� SUBDIVISION: NORTH ARROW „ J-1 - - -` - -_ Yil ' i CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT) STREET ADDRESS INATURE yI ;•).,f;;.��w:1 C., - - � �r.� "� �.5 .-'.-� - DATE TOWN STATE ZIP INSPECTED BY TOWN DATE TELEPHONE NUMBER WHITE -- TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER