HomeMy WebLinkAboutDrain Layers Permit 432 Buckland Road (2) TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. � 7467 Contractor JACQUES CONSTRUCTION (JOHN)
Location Address 67 RIDGE ROAD
Type Work RPR SAN LAT SOUTH WINDSOR CT 06074
No. (860 )432-1823
Date Insp Needed 16 O s7 L6- .
Time Insp Needed a ��
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Pm if No: ` 7467
Town of South Windsor, CT
Permi�t `Qato 0,/12/2002 Drain Layer Permit !1
Expirationl,Date 08/11/2002 ,
Descrip: ,EXTEND SEWER LATERAL TO KATTEN PROPERTY
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Applicant Location
Name JACQUES CONSTRUCTION JO J r. 4 BUCKLAND ROAD
Addr. 67 RIDGE ROAD I E AT BUCKLAND COURT
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SOUTH WIND50R CT
Phone No. (860)432-1823
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The Drain Layer a i } as cense issued by the
state and hereby agr es t nd i s set forth in the
attached 'Conditions' 1 a with Town ofSouth
Windsor standards, al u e s, t ached conditions.
c}Issued By G-(ZNA ` ` o
Date Inspected By
4-74C-7
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR _
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Location of proposed work: �f.3 a �b cA4 (KnJ Lot #
Street No. Street Name
Premises owned by: (64,-:?
— T t e 00 Phone:
Name of Firm: , y
/
Address of Firm:�� R ( i� chi
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with 3
Existing Water Supply: Public Water ✓ Well
Proposed Start Date & =: Estimated time for completion IDA
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 ACzc-452v-&-5 the holder of Drain
Layer's License No. 'd0 � . Only holders of Pi or P7 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.
Signed: Print Name: ����
Lic sed Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
4 ' TOWN OF SOUTH -VI N DSOR
SANITARY SEWER LATE RA*_E.-LD LOCATION
DATE OF CONSTRUCTION: IZ
BUILDING ADDRESS
STREET
SUBDIVISION:
NORTH ARROW
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