HomeMy WebLinkAboutDrain Layers Permits 61 Schoolhouse Driv 1.900053 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
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DATE: 05/09/2019
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GIS ID: 81200061 FEE: 80.00
MUNIS APPLICATION# 201900905 ;t EXPIRATION DATE: 06/08/2019
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APPLICAN'L' >L :sr LOCATION
NAME: EAGLE EARTHWOI SEfW ADDRESS 11 SCAOOLHOUSE DRIVE
ADDRESS: 101 N MOUNTAIN O D ' k OWNER � AbWWRINO BUILDERS INC
i4 r 4baCHAPEL ROAD UNIT 3-F
CANTON,CT 06019
PHONE 860 691-�U�7itir
WORIC DESCRIPTION: NEW SYWl:ta
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THE DRAIN LAYER ASSIGNED TO THAPERIIT H,�S A VOID ICI`FSE ISSUED$eft TH1 STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FOR` H'TI�T THE;ATTACHED`G�QNDITIONS' ALLWORK SHALL$E IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDAIASALL bS)IA RE�[IIIEMEI�T1 S7 SAID THE ATTACHED CONDITIONS.
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ISSUED BYJ DATE INSPECTED INSPECTED BY
5/9/2019 10:01 AM
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PERMIT NO.:_-I
LOCATION: -S
TYPE OF WORK:_
DATE INSP.
DATE INSP NEEDED:
INSPECTED BY:
• WORK.IN .•. . � ���
PROGRESS:
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s/maltaArins 2014 Town of South Windsor 1NPSWMN
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: C� / L1 'f �C��'� ' ��'� Lot #
Street No. Street Name
Pre m i ses own ed by: /a14110(At"14U
Name of Firm: ,�,,6 f ��' L� Phone: ' ) y� Z1Z�
Address of Firm: /01 �;���c� �f_ l v�� V
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
Existing Water Supply: Public Water_ Well
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Proposed Start Date_ 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 )' ICv(�_ the holder of Drain
Layer's License No. /(Q . 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: ,'6J4-- �. Print Name.
Licensed ?Drain Layer
Date: � ' ) 7
Standard Forms\Permfts\APPLICATION FOR DRAIN LAYERS PERMIT REVISION 3/2018.doc
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION.
BUILDING ADDRESS .
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STREET i�v��-e.
SUBDIVISION:
NORTH ARROW
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CONTRACTOR {PRINT NAME OF CONTRACTOR'S SUPERVISOR (P NT)
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STR ET ADDRESS �` SIGNATURE
DATE
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TOWN �. ; STATE ZIP INSPECTED BY TOWN
DATE
TELEPHOWE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER