HomeMy WebLinkAboutDrain Layers Permits 25 Schoolhouse Driv 1900076 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 06/17/2019
GIS ID: 81200025 FEE: 80.00
MUNIS APPLICATION# 2019012675,PEXPIRATION DATE: 07/17/2019
APPLICANT LOCATION
3,
NAME: EAGLE EARTHWORK SRU ADDRESS 2S SCIOOLHOUSE DRIVE
ADDRESS: 101 N MOUNTAIN qpO O T R MANNARINO BUILDERS INC
x 440 CH4WEL ROAD UNIT 3-F
CANTON,CT 0601 r
PHONE 860 693�-2927 7
S,
WORK DESCRIPTION: NEW S Wl ' COI CTrbN-
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THE DRAIN LAYER ASSIGNED TO THIS PEIrITFIAS. VAL1D LT+ E1 $E ISSI11'7 BY THB STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTk�M fN SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDADS,ALL OSHA REQUIREMINPS,AND THE ATTACHED CONDITIONS.
ISSUED BY DATE`WSPECTED INSPECTED BY
6/17/2019 3:37 PM
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TOYVN OF-SOUTH-WINDSQRTNSPECTID N REPORT
PERMIT"NO.: CQNTRpCTOR:
LOCATION:
TYPE OF WQRK:
D�4T INSP NE:
DALE INSP:_
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INSPECTED BY:
WORK.IN
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SEPTIC TANK PUMO _SMASHED;FILLED: - : 1lVTTNES5ED ❑YES NO
AS-BUILT; •
DATE: -1
S/moljq f.2014 Town of South Windsor•IM SkMN REPORT 1.4
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: -S ltnd l kowc- Of Lot #
Street No. Street Name
Premises owned by: Rizzi e 1/7e2 `
Name of Firm: c- �a '(,� r�s Phone: f0
J
Address of Firm: / e _ 4 ✓f /Od.
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
J(
Connection will be made with ep lc
Existing Water Supply: Public Water_ Well
Proposed Start Date w — 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 Cc2�e� (�-'Y 2� °`
the holder of Drain
Layer's License No. 7 r 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: e ? qe'
Licensed Drain Layer
Date:_ `
Standard FormsNPermRs\APPLICATION FOR DRAIN LAYERS PERMIT REVISION 3/2018.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
P
N
BUILDING ADDRESS
STREET . � •
SUBDIVISION:
NORTH ARROW
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CONTRACT PRINT) NAME OF NTRACTORt SUPERVISOR(PRINT)
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STREET ADDRESS SIGNATURE
TOWN STATE ZIP INSPECTED BY TOWN
0 DATE
TELEPHONE "BER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER