HomeMy WebLinkAboutDrain Layers Permits 94 Longmeadow Drive 1.900087 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DAT
E: 07/29/2019
GIS ID: 54670094 AFEE: 80.00
MUNIS APPLICATION# 201901586 ,EXPIRATION DATE: 08/28/2019
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APPLICANT I,,QCATION
NAME: SSC CONSTRUCTION LLC ` ' �AL]D1SS '`` 4 L'4JNGA!IADOW DRIVE
ADDRESS: 1700 SAYBROOK ROAD r OWNER TOI I:LAMXVIII LIMITED PARTNERSHIP
CILT R IDCEBURY ROAD
MIDDLETOWN,CT 0645
PHONE
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WORK DESCRIPTION: NEW SEWER,G'ONNCTTON S
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THE DRAIN LAYER ASSIGNED TO THIS PE1MI1 A VALID°LICENSE� SIJIv $Y THE,S`T1TE{AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH IN HE ATTACHED`C01�1DI�INNS' ALL WQJtI��S:l1ALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS`ALA OSHA I QUIRIE, NTS,AND THE% "N ICHED CONDITIONS.
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ISSUED BY DATE INSPFGTED"'' INSPECTED BY
7/29/2019 9:18 AM
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TOWN OF SOWN WINDSQR INSPSCIIDN REPORT
PERMIT 200,P7 CQNTRAC '.: Ca 10 S- �
LOCATION: `
TYPE OF WORK; NO, 0 z.
DATE INSP NEEDED•. DA7EINSP:. �f3fi�
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S/mclloy/f Ms ZM4 Town of South Windsor MPS&MN WORT 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: <: Ll l'UnS✓�'t� r7� 1 � Lot *
Street No. Street Name
Premises owned by: �O 1 �'� --'n C—
Name of Firm: :5Z Cons�roc zol'-� O C— Phone: �6c� 2SU•23 3
Address of Firm: i700 gyro 1-L rzo M,C)ot2lwfl C k.
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 CommerclaVIndustrial Building number of acres
Connection will be made with
Existing Water Supply: Public Water Well
Proposed Start Date 7 30, f Estimated time for completion �d' /�
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 sa`��' - C°�'" `�• the holder of Drain
Layer's License No. K"'' OZY7f4/p . 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. Zo(`�3 100 ZZ n PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 7S FEET OF A WELL
IT MUST BE.AIR TESTED .
Signed: Print Name:
Licensed Drain Layer
Date: Z� l C?
Standard Fcrms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT REVISION 3/2018.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 7 3 � - z9
BUILDING ADDRESS 9
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTORS'(PRINT) NAME 0 C TRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
/X? i� � cu. �� -- '� � �' .�i DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMB R
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER