HomeMy WebLinkAboutDrain Layers Permit 35 Brightman Circle TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 8018 Cont;ra'C'tor `J & H SLAVER CONST CO
Location ZE Rddre s 75 CMM: RCE"WAY
Type Work NEW SA T ` S'l}UTH WINDOR CT.,-06074
Date Insp Needed --------------
Date Tnsp 'i
Time Insp Needed ------------
tame IT {
Inspected By
Work in Progress T
— P'L_-_�at�ro
fi
__ — —
Permit No. 8018 Town of South Windsor, CT
Permit Date 01/11/2006 Drain Layer Permit
Expiration Date 02/10/2006
Descrip:
APp
li can pp
t I
R
ca•t i.on
Name J & H SLATER CONST GO i.ld'r 382 -CIRCLE...
Addr. 75 COMMERCE WAY owner
SOUTH WINDSOR CT- 06074 _
Phone No. (860)528-52* 2
The Drain Layer dsigne t1sexna hasa1xd lx:cens�e "rued by the
state and hereby a re., ; 'to: > 7_::;.,._
Y g &;.,, the terms '. ... canc'it: o.riss<<set.:.:for;£h in the
attached 'Conditionst;."'1�7.1 wa l':s'h l'° � d dance' with 'Toj,+n of South
Windsor standards, all. OSIA '` e juir2{rit _s;,,. d >e att>aieds... 'o "G ziditions.
Issued By
Date Inspected ":'
--------------------- Iris1..E;:d.�.:e:d.,::BY
.' APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work:_ �:�iZ1 G +�,i,�t� J 13L, Lot #
Street No. Street Name
Premises owned by: �-
Name of Firm: Phone:
Address.of Firm:
TYPE OF WORK:
Lay House Drain . Repair House Drain
Lay Main_____`___ Lay-Lateral-for Commercial/Industrial
Building of acres
Connection will be made withwrC
Existing Water Supply: Public Water Well
Proposed Start Date Estimated time for completion
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.
�-
n
�--, 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 an attached thereto. Applicant has received
Town Street Excavation Permit No. �
and/or ConnDOT Permit No.
CBYD No.
ti
Signed:
Print Name:_ -J l t 1"I
Licensed Drai Layer
Date:
Standard FormAPermiWAPPLICA71ON FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER : LATERAL FIELD LOCATION
DATE- OF CONSTRUCTION:
BUILDING ADDRESS : ;BelG fW Q a(.Lt
STREET ►tN►1�►f C-i(-CtL
SUBDIVISION: &ZgA; jTn-i" ci I'Z(,
NORTH ARROW
-r--
fWCA
I CA
� � t
I
I
LLLJ
CONTRACTOR (PRINT) NAME OF ONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SI TURE
SUUw 5(m
IIJd N� - C i DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS Le,7 y
STREET : �S �/-►'y y�`'.��h �!1-c,>�
SUBDIVISION:
NORTH ARROW
t
i
t
1 - f
a
-
t
r S
1 i '
I
t -
' I
I
CONTRACTOR (PRINT) NAME 0 CONTRACTOR'S SUPERVISOR (PRINT)
73' eu e k/ati
STREET ADDRESS SIGNATU
of�r/9vr C� CJ G�?y /t DATE
TOWN STATE ZIP INSPECTED BY TOWN-
_ 0 5�4- S DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER