HomeMy WebLinkAboutDrain Layers Permits 12 Longmeadow Drive 1900084 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
DRAIN LAYER PERMIT
DATE: 07/16/20I9 = :ry
GIS ID:54670012
MUNIS APPLICATION# 201901440 FEE: 80.00
r EXPIRATION DATE: 08/15/2019
APPLICANT 3;
NAME: SSC CONSTRUCTIO LI,C k LOCATION
ADDRESS 1700 SAYBROOK RO 'A ADDRESS 1210NGMEADOW DRIVE
OWNED 'I"QLI LAND XVIII LIMITED PARTNERSHIP
MIDDLETOWN,CIOb577CLD3IDGEBURY ROAD
PHONE s
i
� i ya
WORK DESCRIPTION: NEW SEI C(jNIVCTIbN
i r
THE DRAIN LAYER ASSIGNED To E THIS PE IIT HAS A VALID LICENSE I..SSUEb$7� I HE'STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTI I"N NHL ATTACHED `� NDITIQNS' 1I L WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STAND AL ALL OSHARE
QIJIEM
RENT S kAND TII) ATTACHED CONDITIONS.
5 L .a
ISSUED BY DA E INSPECTED
7/16/2019 10:17 AM INSPECTED BY
I
: k
"fP
F
k
;.y '
v
4 S a l W C 2Y
t
01
TOWN OFSOUTNMINDORINSP111MOR REPORT
NO,: UD �L CONTRACTOR: CSC° ��h
PERMIT .
LOCATION:
TYPE OF WQRK. O
D A INSP NEEDEf • DATE
INSPECTED.
MAKIN
PROGRESS: � . kL s
.. • c
�r' ✓ - JC¢ dsrot
SEPTIC TANK PUMPEQ '. ...HED- F;LLED . . 1NITNESSED ❑YES 0 NO
AS-BUILT:'
INPUT: DATE: "
•_ 4
_ 1
5/moltoy/forms 2U4 Town of South Windsor•INPSEtMN 1REPORr 14 j
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: (or* � Lot
Street No. Street Name
Premises owned by: Tocl f.3(0s TOC.-
Name of Firm: C'SC �:r , krvc4.a/ l ( C__ Phone: 2so,23 f 3
Address of Firm: 17bo S� !fr .2•] �c�Ju �wrl
TYPE OF WORK:
Lay House Drain <Reppair House Drain • Sanita Disconnect
ry
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 sr;v"z
Existing Water Supply: Public Water Well
Proposed Start Date 7 l6. Estimated time for completion 12, 15
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 SG{v�l Ca►M „n � the holder of Drain
Layer's License No. PIM 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. l�l Z�C)i s 6 _ PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE.AIR TESTED .
Signed:
Licensed Drain Layer
Date: 2,
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 I � d O ) 9
BUILDING ADDRESS '
STREET r e Qe� •�� r J C
SUBDIVISION: aro s,� �
NORTH ARROW -
ri
,
-
�
E tTD, Kiw-
,'_
CONTRACTOR (PRINT) NAME C NTRACTOR S SfJPERVISOR (PRINT) -
STREET ADDRESS SIGNATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
��7 Um DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER