HomeMy WebLinkAboutDrain Layers Permit 40 Brightman Circle I
TOWN OF SOUTH WINDSOR INSPECTION REPORT
`Permit No. „',7987 ContrAC't'br J & H "SLATER CONST CO
Location )r*a,7' PI(�fY'I14AK CIRCLE Address '`;`75 CIITKMFRCE WAY
Type Work NEW SAN LAT , _UTH V$TNI3SOR, C ... 06074
Phone hfo (BLt)58 52
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Date Insp Needed ------____-- D`at Issas
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Permit No. 7987 Town of South Windsor, CT it
Permit Date 10/24/2005 Drain Layer Permit
Expiration Date 11/23/2005
Descrip: INSTALL SANIT. SEW. ,,T11TEF{}17
Applicant
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Name J & H SLATER CONST COdd g.0 BRIGHTMAN CIRCLE
Addr. 75 COMMERCE WAY - ff""'e' r,,_RSK-KE TaCO
SOUTH WINDSOR CT.,06074:;
Phone No. (860)528-5252
The Drain Layer assigned. this perm, t hss vaxi :]i enact i.a,Bied by the
state and hereby agrees to ck :l the `terms'`and carrdittin bt.. orCh in the
attached 'Conditions�;.'"'Xill -work sh 11 h .,t s c't�.rdanbe with Tbon of South
Windsor standards, a13 OSHA""requ 'rirst` .;; ,? rid .be at
Issued j'
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Date Inspected --------------------- I nsj5;et,tda.:,.gy ---------
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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 $60.00
Location of proposed work:_ /6-.,, 1��y1,tf��J C'i Lot #
Street No. Street Name
Premises owned by:
Name of Firm:_ <� � �� t AiS( Phone: Z
Address-of Firm:
TYPE OF WORK:
Lay House Drain X Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water Well
Proposed Start Date Z6-A<7 Estimated time for completion � L
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 "'L the holder of Drain
Layer's License No. 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 a9d attached thereto. Applicant has received:
Town Street Excavation Permit No. _k lye- and/or ConnDOT Permit No.
CBYD No. 3 6 �566
Signed: .
Print Name:_ 1U.'I
Licensed Drain Layer
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Standard Forms\Permlts\APPLICATION FOR DRAIN LAYERS PERMIT.doc
• TOWN OF SOUTH WINDSOR
SANITARY - SEWER LATERAL FIELD , LOCATION
DATE OF CONSTRUCTION: 0 /Z�,/os
BUILDING ADDRESS
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CONTRACTOR (PRINT) NAME 0 CONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS
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CT. OW-7 , � , DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER