HomeMy WebLinkAboutDrain Layers Permit 0114 Avery Street 1800079 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
DRAIN LAYER PERMIT
DATE: 10/26/2018
GIS ID:06300114
MUNIS APPLICATION# 201802119 FEE: 0.00
EXPIRATION DATE: 11/25/2018
APPLICANT
NAME: RED TECHNOLOGIES L C+, k s=F �' i4r -OCATION
ADDRESS:, 10 NORTHWOOD DRIVE E ADI3RESS 114,AVIY STREET
54,
y ORCATiOIP REALTY INC
BLOOMFIELD,CT 06062'` F 421 SA '13RDOK RD
PHONE
0, S :t
2,1 Yi
WORK DESCRIPTION: AVERY S I{ gg
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RCONS SUCTION PIOJ1yCT1Q FEE S
THE DRAIN LAYER ASSIGNED TO THIS Pil T
THE TERMS AND CONDITIONS SET FORTI HAS A VLID T.IG`I{NSB TSSUEb BY 1ITATE AND HEREBY AGREES TO ALL
THE TOWN OF SOUTH WINDSOR STANDAOSS"- L GSAITHA Q R{�EN J�s A TD)LEri gCHEDL BE IN CONDIT CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED BY
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. - TOWN OF SOUTH-.WIN.. DSal k INSRECON REPORT
PERMIT NO.: - /Roo "7 CONTRACTOR: '•3l 1��c'�t✓�r�fta,�� �
LOCATION: y Aov r�4 S
TYPE OF WORK: I t S _ C 12Sy� 1 C>i'L
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DATE INSP NEEDED: DATE INSP: y `I
INSPECTED BY: cQfs �►-? , e�s� -
WORK IN
PROGRESS: IF,141>-31,13Cb L.A"TV,51ZA` , c ,— .n� r� g c� AJEw S)DEWALk. ,
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SlmolloJrtm s 2014 Town or South Windsor Impsk>DON REPor 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: \ / t n 1,at' �> Lot #
Street No. Street Name
Premises owned by:
Name of Firm: 2zs C�"1,u lk,X�c> �? k+- -� Phone: 66D-'7- 35 Z,'IZS
Address of Firm: 1 0 C X Q�ic�Z—
TYPE OF WORK:
Lay House Drain ; Repair House Drain ; Sanitary Disconnect
Lay Lateral for building with connection C ; or no connection ;
Lay Main
Lay Lateral for Commercial/Industrial Building number of acres
Connection will be made with Cam"
Existing Water Supply: Public Water Well
Proposed Start Date '4°1 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 the holder of Drain
Layer's License NaPl- .r� `c �r� c� 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: �
sed Drain Layer
Date: \cam-�"� L3
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT REVISION 3/2018.dcc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: �✓ Z�� ��
BUILDING ADDRESS '� r�-6`
STREET
SUBDIVISION:
NORTH ARROW
E
t/
CONTRACTOR (PRINT) NAME OF CONTRACTOR'S UPERVISOR (PRINT)
STREET ADDRESS SIGNA R
b6 of DATE
TOWN STATE ZIP INSPECTED BY OWN
a�aD� A6v7. _ _ DATE
TELEPHONE NUMBER
WHITE -- TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER