HomeMy WebLinkAboutDrain Layers Permit 55 Brightman Circle TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7968 Cont. 'act'or J'&'1"SLATER CONST CO
Location 55 BRIGHTMAN CIRCLE Address_ =i'%'75 Amaw E.;.-;MAY
Type Work NEW SAN LAT
,,..: .0;U_TH W`fiND$OR. CT,.,06074
Phone No (860)5 ,8 552 ;
Date Insp Needed Date I;as Q.
Time Insp Needed < Time IY3i
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Permit No. 7968 Town of South Windsor, CT
Permit Date 09/22/2005 Drain Layer Permit
Expiration Date 10/22/2005K<'
DescriP: INSTALL SANIT. SEW. ;XiATER'\LV'
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Applicant
Lo a>ti on
Name J & H SLATER CONS,-..T. :CO ': Adc 5�a $RGTiTM7s,I�'CIRCLE
Addr. 75 COMMERCE WAY OWtiier _RSK KET� CQ, INC.
SOUTH WINDSOR CT.,06074 {
Phone No. (860)528-5252., '
The Drain Layer signed Christ 1? s u :l:id:.l: yens . sued by the
state and hereby agree ""tci'a l'<the 't'erm "`aria` cY2t` t; 'in: :;« .¢t:forth in the
1
attached 'Conditions? .,A'll woxk � iaf g. ..Z.F. srdance wa.tk Town of South
Windsor standards, all: OSHA`'`rec;uYtnzi' atta'Cfiec:.=,cbn'ditions.
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Tzt�.e..
Issued By �rJ /� -_« ::
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Date Inspected -------------------- I risS 'C ' 2t''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: Lot #
Street No. Street Name
Premises owned by:_ l`=
Name of Firm:_ J Phone: Z -
Address.of Firm:_ �S �' ,t ✓��r�1 ¢-
TYPE OF WORK:
Lay House Drain Repair House Drain
Lay Main . ; '
y Lateraf for Commercial/Industrial
Building of
acres
Connection will be made with P- /(
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 � ui. T�fL the holder of Drain
Layer's License No. "7 TLI 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 and attached thereto. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No. 20�J 3,�O t:Sl
Signed:'% Print Name:
J' Licensed Drain Layer
Date: Z 6y
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD . LOCATION
DATE OF CONSTRUCTION: �- �� o S
BUILDING ADDRESS � -.: ��
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SUBDIVISION:
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CONTRACTOR (PRINT) &NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
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TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER
TOWN OF SOUTH ANDSOR
SANITARY SEWER LATERAL 'FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS G
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OFCONTRACTOR'S, SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
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TOWN STATE ZIP INSPECTED BY TOWN
6LC(/ -5-.' S3.S`2 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER