HomeMy WebLinkAboutDrain Layers Permits 111 Longmeadow Driv 1900086 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 07/22/2019
GIS ID:54670111 FEE: 80.00
MUNIS APPLICATION# 201901498 EXPIRATION DATE: 08/21/2019
APPLICANT
OCATION
NAME: SSC CONSTRUCTION LLC AbDTtISS I>1 IbNG1VSEADOW DRIVE
ADDRESS: 1700 SAYBROOK ROAD OWNER 'f�t LA II)XVIII LIMITED PARTNERSHIP
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42 OLD RIDf'EBURY ROAD
MIDDLETOWN CT 06457
PHONE
WORK DESCRIPTION: NEW SEWED,CONI`1EC) O1N`
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THE DRAIN LAYER ASSIGNED TO THIS PEIkII'I`HAS A VALID LTGENSL ISSUIE 3 $iY TFIEyST ►T>r AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH Will ATTAC NS' ,ALL WdT y SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARD Sx ALTs OSHA REQLIIREIV])NTS' AND"iHE Al rI CRED CONDITIONS.
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ISSUED BY DAT E"TED INSPECT BY
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LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DAM
INSPECTED BY: •Lb
MAKIN
PROGRS: �-tea r ,1,.5 . .D lZ .73
SEPTIC TANK PUMPEQ;SMASHED; FILLED WITNESSED ❑-YES [J NO-
AS-BUILT:
INPUT; IPA..- DATE: a
5/moitoy/f aM 2014 Town of South Wiodsor•MPSW[i_ON REPORT 14 f
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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: «< log (mac tj O✓t. Lot #
Street No. Street Name
Premises owned by: to\% 113 ems. 'Z Y?e—
Name of Firm: 65 C Cc>4sA,r'Jc-�'0--\ t t C— Phone:
Address of Firm: 76G Cj6crS 7
TYPE OF WORK:�,,- R
Lay House Drain fir 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 r 5,011L
Existing Water Supply: Public Water Well
Proposed Start Date -7 2 2. 1� Estimated time for completion -7• 2 Z'
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 No. p DZ878"�l ( . 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. 2� �c1 21�0 {S�. t PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE-AIR TESTED .
Signed: Print Name: { wr�--
Licensed Drain Layer
Date: 7 'al. 1
Standard Forms\Permits\APPUCATION FOR DRAIN LAYERS PERMIT REVISION 3/2018.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: ? t c7
BUILDING ADDRESS
STREET
SUBDIVISION: Sc�
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER