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HomeMy WebLinkAboutDrain Layers Permits 359 Ellington Road (2) 1900015 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT 3 DATE: 02/05/2019 r 1 C h y}t Yh. GIS ID:30300359 s: l FEE: 80.00 MUNIS APPLICATION# 201900235 _llillf �li EXPIRATION DATE: 03/07/2019 ( vs.n t.r 1 < \ 4 s APPLICANT s �T �� � {' LOCATION NAME: PIERCE BUILDERS,dI�G . i ,y ADDR$ 5��EL INGTON ROAD ADDRESS: 522 SALMON BROOD A LL PROPERTIES#344,LLC nt RIER CROSSING BOULEVARD GRANBY,CT 0603 ¢k i' a �ha h i JIr 3°0 PHONE 860-65�7�ff� 1 t R� , t 4 ii�it ,` 4 fz t i i t t^ �f S '' ( jr 3`f v�h5 (rssFt u WORK DESCRIPTION: ON SIT�S W QI`TE LAYATE AL/INDUSTRIAL BLDG COKE coBU ni7II,I 2i5 'AcEs�z x�wr 3ry, (. . u t j f ii tit lY y Sn 5�a THE DRAIN LAYER ASSIGNED TO THIS��jPE SIT I S A S/t LIA f -djoir ISSi� 'BYT ESTATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FOR 1xH M THE t�TTAI✓T Dxs+ D+1�1T O1 S' ��4 "y ORK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDAI JS,Al I hbSH RE�UIREMFWg,M0 TIME ATTACHED CONDITIONS. / 1 4 r ISSUED BY DATE INSPECTED INSPECTED BY 2/5/2019 11:39 AM 27 ' th k.}` �• 9 EY`Ark '�'� 'k�v ,� 1 �•4 f�Y�', �'•�7''YU iF cj�� �� h .n t! `"� '��`xz s� y �t' '� ���4� S:tis �,f � i��3'�4 � } y '•ii ON ^"�,€ �tsiskXjr€ a'1 . l two Fy 4K a �s ry r�i ,nn��xt fVi y*4t1 � IN Ji S,i•t i�ly 4 I .. 6 I TOWN QF SOUTH WINEWR MSj'EMf4 REPORT PERMIT ND.: CON TRACMR: _ P, iul16LS. j LOCATION: 3 s l £11.�� TYPE OF WORK: 1 D�kTE INSP NEEE{ ; DATE INSP;� INSPECTED BY: a a WORK IN PROGRESS: -t L, �rJ.r+itc! ✓�<z i'd 2 /0 e) U SEPTIC TANK PUMPED,.SM'A�SHED. FILLED : 1MITNESSED ❑YES El NO- AS-BUILT- ' �! INPUT.-____- DATE.'_- 1 Vmolioy/fiorms 2M4 Town of south Windsor MPSEL" MN REPW' 14 j r 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: ' l`GG ve%'7aiJ .�� Lot #� Street No. Street Name Premises owned by: Sc sa76 JV Name of Firm: & .[Sy�eD�RS �� , _ Phone: �� y Address of Firm:- &O 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 C number of,95)-Acres � ? o0L, Connection will be made with �� Existing Water Supply: Public Waterer Well Proposed Start Date Estimated time for completion /Ilel 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 z Amfe 7;c the holder of Drain Layer's License No./-//,I_©90 830- . 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: Licensed DrafiT Layer Date:— Standard Farms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT REVISION 3/2018.doc