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HomeMy WebLinkAboutDrain Layers Permits 20 Longmeadow Drive 1900081 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 07/02/2019 GIS ID: 54670020 FEE: 80.00 MUNIS APPLICATION# 201901384 EXPIRATION DATE: 08/01/20I9 V APPLICANT LOCATION NAME: SSC CONSTRUCTIO�+TSL&C ADDRESS "L0'`T ON rMEADOW DRIVE k: ADDRESS: 1700 SAYBROOK RdMf) `5 h rt 01 INER TOLL UAND XVIII LIMITED PARTNERSHIP ( I D ifUDGEBURY ROAD EF n ��.. MIDDLETOWN CT�0#457 PHONE ' Svamm ?: y e• k t�'I �� :y U WORK DESCRIPTION: NEW SHWEI�Cd cTr©N i . s 'v e t' THE DRAIN LAYER ASSIGNED TO THIS�PERI1'BIAS A VAl,ib 1SICNSE iSSUET $Y TI3E"STATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FORTH IN THE:ATTACHEI3`GONDI 'IQI9' .tI L WORK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDARSDS ALL OSI A H;QUIREMENTS,AN1a fHE ATTACHED CONDITIONS. y ty � ISSUED BY DATE INSPECTED INSPECTED BY 7/2/2019 3:10 PM t y { t". x C >i it Y y hl 1 k 1 PR T y .k• F" yyi r d . 3 fJ * :. TOIIUN OF-SNUTNf WINDSORINSPEMON REPORT PERMIt' . . - . • . LOCATION a TYPE OF WO DATE INSP NEEDED: : DAIE INSP: - I INSPECt'ED-By: . WORK:IIV PROGRESS;._ SEPTIC TANK PAMPER,5 . . ED, FILLED WITNESSED ❑ S N0 AS-BUILT:- ` INPUT: -- DATE'•__. SimaIIoy/foans=4 Town of SOU Windsor•MPSS=14 tgfb T14 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: zd �Q�� °°'�'`'� Lot # G�3 Street No. Street Name Premises owned by: o t rams. TO C Name of Firm: �,ate Phone: rGo- Zsv Z 3 t 3 Address of Firm: TYPE OF WORK• .Lay House Drain�epalr House Drain ; SanitaryDisconnect 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 saw Existing Water Supply: Public Water well Proposed Start Date '7. 1 rc� 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 5ktvak""�-- ��-��. the holder of Drain Layer's License No.Q;f7firr - �'� . 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. 2a r 2 56 '3 7 a 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: Standard Forms\Permits�APPLICATION FOR DRAIN LAYERS PERMIT REVISION 3/2018.doc i TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: ,9-0/ 9 BUILDING ADDRESS _ Lo q,3 STREET . SUBDIVISION: NORTH ARROW 1*6 0A lei -�-- -� . 7 f I 7 , , r - f .,.,SSA �C� CONTRACTOR (PRINT) NAM O CONTRACTORS SUPERVISOR (PRINT) 70 d AW 711 STREET ADD ESS SIGNATURE DATE TOWN STATE ZIP INSPECTED BY TOWN 8& - DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER