HomeMy WebLinkAboutDrain Layers Permit 026 Cardinal Way 4.
TOWN OF SOUTH WINDSOR 1NSPECTION REPORT
Pevivit No. 6756 Contractor JMJ CONSTRUCTION CO,
L.oca.tion 26 CARDINAL. WAY Address 658 ELLINGTON ROAD
Typb.Work NEW SAN t.AT SOUTH WINDSOR OT 06074
Ptrc��� No. i ESt�U 1528--7889
Date Insp Needed Z� t Date Trasp
Time Insp Needed --- 'Time InSp_.
Inspected By
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Input r'< - - Date
Permit No, Town of South Windsor , CT
Perm-it Date 02/ 1 i / 1 99€3 Drain Layer Permit
Expiration Date 03/ 1;3/ 1996
Descrip;
Applicant Location
Name JMJ CONSTRUCTION CO. A,ddr . 26 CARDINAL WAY
Addr. 658 ELLINGTON ROAD Owner CLARta REALTY, INC .
SOUTH WINDSOR CTiEi74
Phone No. (860I528-7889
The Drain Layer assigned this permit'has � val'i,d 1,fcense issued by the
state and hereby agre4s to "aI.'l .'the ' te- rms ,anti conditions set forth in the
attached 'Conditions ' . Al 1 :work, sha` l ba i�n accor�dancs" with Town of South
Windsor standards , a l t OSF4A. r"4qu !"'emr4nt:t3, and the , attached conditions .
Issued By Title
Date Inspected Inspected
_ _-----�-t-t 1-1-�3- _._� ___ _ �P cued B y (�
APPLICATION FOR DRAIN LA YER S PERMIT # 67 S 6
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work: / Lot #
Street No. Street Name
Premises owned by: / CST
Name of Firm: Phone:
Address of Firm: 157
TYPE OF WORK:
Lay House Drain�_; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with Sp R �
Proposed Start Date �,—// Estimated time for completion f
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. ly h9iders of P1, P7 & W9 licenses will be
issued a permit. Permit will expi 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.
Signed. ��--�� � Print Name 75Aef 5g erg
Oe-
LicerkWd90a-in Layer
Date: "�
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: _
BUILDING ADDRESS 45 t
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STREET : l �
�- SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
DATE
TOWN STATE ZIP INSPEC BY TOWN
DATE
"10NE NUMBER
E - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER