HomeMy WebLinkAboutDrain Layers Permit 45 Brightman Circle i
t TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 79 Contractor J & H 8*LA7,'ER CONST CO
Location '' Oft t�IZN CIRCLE A dresta�..`:< 75 G'CMMERCE NAY
Type Work NEW SAN LAT WIN&1OR. CT::.,.06074
Phone,,''NQ (8 0_)528 5252 .:.
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Date Insp Needed Date Insp
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Time Insp Needed ___.. (_� _—�
Inspected By
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Permit No. 7993 Town of South Windsor, CT
Permit Date 10/27/2005 Drain Layer Permit
Expiration Date 11/26/2005
Descrip: INSTALL SANIT. SEW. I,ATERA
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Applicant
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Name J & H SLATER CONST ( 0
�'iCt ;r} 45-,R*Vg`IiTMAN.CIRCLE
Addr. 75 COMMERCE WAY 64:9r RSK KELhCO INC
SOUTH WINDSOR CT .06.074
Phone No. (860)528-52. 2;,..> .
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The Drain Layer assigned thj s tit3 G- has a uy 1d licerss issued by the
state and hereby agreee :ta a ` ,the '�rms anz cord"x3 E�bn set:forth in the
attached 'Conditions 1 :i3 d.n :w th Togas of South
Windsor standards, all. OSHA requiretT4.4ts.. c nd 1#e atta hecE, ontlitions. ;
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Issued By ------=J` � 1� Tfqz
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Date Inspected -----------------
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH.WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, Cr.
FEE $60.00
Location of proposed work: (Z� Lot
Street N --
o• Street Name
Premises owned by:
Name of Firm:_`�1
Phone:
Address.of Firm:
TYPE OF WORK:
Lay House Drain___ _; Repair House Drain
La Main - '
Y ; Lay Lateral-for Commercial/Industrial
Building of acres
Connection will be made withVC
Existing Water Supply: Public Water-- Well
Proposed Start Date (i Al 6 57 Estimated time for completion _ 1tir -
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_J `��t Imo.P
. Layer's License No. �?7 �' the holder of Drain
will be issued a �� Only holders of P-1, P-7 or W-9 licenses
pen-nit. PERMIT WILL EXPIRE THIRTY(30)IDAYS 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. _cam..-c c `'j- `�V 1
Signed: . Print Name: °�i iu J u+16L
Licensed Drain Lay r
Date: L z'1/C
Standard Forms\Per niks\APPU AIION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
-SANITARY SEWER LATERAL :FIELD LOCATION
DATE OF CONSTRUCTION:BUILDING. ADDRESS
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CONTRACTOR (PRINT) NAME OP CONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS, SIGNATUfft
S Alj'�)c/-01 C!?� D 6 0 7 Y DATE
TOWN STATE ZIP INSPECTED BY TOWN
�6 U 5 - f S`Z., 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
STREET of-c/r
SUBDIVISION: 6&_l
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS SIGNAT E /
,S t d."*d//vi. G �/��/ Z�,.=.�.,.� _711_1 S DATE
TOWN STATE ZIP INSPECTED BY TOWN
e�G ,4�25� S-i3'2 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER