HomeMy WebLinkAboutDrain Layers Permit 043 Cardinal Way a
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 6987 Contractor JMJ CONSTRUCTION CO. !
Location 0043 CARDINAL WAY G07-Z9 Address 658 ELLINGTON ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
Phone _No. (860)528-7889
Date Insp Needed pateIpspr _. /��/
Time Insp Needed Time nepl
Inspected By
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Periirl No. 6987 Town of South Windsor, CT
Permit Date 05/14/1999 Drain Layer Permit
Expiration Date 06/13/1999
Descrip: CK#9006
Applicant Location
Name JMJ CONSTRUCTION CO. e A'ddr,.� 0043 CARDINAL WAY
Addr. 658 ELLINGTON ROAD t Cleaner LA'R:K REALTY INC
SOUTH WINDSOR CTsa4
Phone No. (860)528-7889
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The Drain Layer as�s1 e s , r } �s r t. t) .1 cense issued by the
state and hereby agredes r tQ i l` th►e � `�R _ nd t l�i s set forth in the
attached Cond i t i ons1 �k eh J k n a with Town of South
Windsor standards, all � 1A qrelm
e nd �e at�ched conditions.
Issued By
Date Inspected _ `� I ' : `Insete )
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
3
Location of proposed work: 1A611 of #
Street No. Street Name
Premises owned by:
Name of Firm: S 64 Phone: aZ"
Address of Firm:
TYPE OF WORK:
Lay House Drain �, ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Proposed Start Date -7%o Estimated time for completion I
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 ✓� I eS c TGa e holder of Drain
Layer's License No. Onl holders of P1, P7 &W9 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.
Signed: Print Name: cTMA cQ t)
#hsobrain Layer
Date: r'�
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS LcD f 9
STREET : Cg v-d h I 3
SUBDIVISION: t±," �`e
NORTH ARROW F Fir► Z �� c
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CONTRACTOR (PRINT) NAM OF CONTRACTOR' SUPERVI OR (PRINT)'
STREET ADDRESS / SIGNATURE
DATE
TOWN STATE ZIP INSpy I ED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER