HomeMy WebLinkAboutDrain Layers Permits 114 Longmeadow Driv 1900100 TOWN OF SOUTH WINDSOR
PERMIT NUMBER , CT
DRAIN LAYER PERMIT
DATE: 09/23/2019
GIS ID:54670114 '' v
MUNIS APPLICATION# 201902126 AT' FEE:
EXPIRATION DATE: 80.00
4 10/23/2019
NAME: SSC CONSTRUCTION I,LG >> LOCATION
ADDRESS: 1700 SAYBROOK RO' D k ADDRESS 114 L?NGMEADOW DRIVE
Tit
Qu LAND XVIII LIMITED PARTNERSHIP
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MIDDLETOWN, .1 0645'7 : ti z 42 OLIO RIDGEBURY ROAD
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WORK DESCRIPTION: NEW 4 's
CTIN
THE DRAIN LAYER ASSIGNED TO THIS PFIIT HAS A VkI ilk LICEI�ISEryISSI7$D$�(TEE THE TERMS AND CONDITIONS SE
STATE AND HEREBY AGREES TO ALL
T F01tTH I1y TI3E ATTADGOAJI�ITION ' ;'.;i4LLWORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDtIJS, 1L1;OSHA RFYIUIREMEIxTTS �41a1I.SHE ATTACHED CONDITIONS.
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ISSUED BY
9/23/2019 8:35 AM DATE INSPECTED INSPECTED BY
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PERMIC NO.: ' 900
LOCATION:
TYPE OF VkftRK:
DATE INSP NEEDED,
DA1E INSP 3 /1 1
INSPEG"CED BY:
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PROGRESS: C.�« r- � . .,,4 `eJ
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LIMPED SMASHED; FILLED WMESSED []-YESC] NO
SEPTIC TANK PUMPED
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INPUT:
DATE: "
S/mcltayi�rtns ltEpORT i4
20WTOM of South Windsor INPSEN
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: 111-f 1026Me4-6w •�-� Lot #
Street No. Street Name
Premises owned by: k(l C-
Name of Firm: kr„c e,r-\ k kPhone: 2 ) 3
Address of Firm:_e 7oa 5'd,,1qfao- 40
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
Connection will be made with 6
Existing Water Supply: Public Water Well
Proposed Start Date 01• Z0• 'cl Estimated time for cornpletion Zc�• r
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 s<+ve-, Gov,-A the holder of Drain
Layer's License No. PlIn 0zCr / 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. Za l� 3 6 D 2( )0 PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE AIR TESTED .
Signed• Print Name: -SwG1 �cw•..�:�- a'
Licensed Drain Layer
Date:
Standard FormsWermIMAPPIICATION FOR DRAIN LAYERS PERMIT REVISION 3/2018.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET
SUBDIVIS
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CONTRACTOR (PRINT) N MA E F CONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS SIGNATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
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TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER