HomeMy WebLinkAboutDrain Layers Permit 9 Church Way TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 8075 Contractor JACQgES''C.ONSTRUCTION (JOHN)
Location 9 CHA$BCH WAY Let a ;Addre 67
Type Work NEW SAN LAT
03i�,;,WINTS' OR 06074
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� Permit No. 8075 Town of South Windsor, CT
Permit Date 07/27/2006 Drain Layer Permit 1
Expiration Date 08/26/2006
Descrip: INSTALL SEWER LATERA,v`
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Ap
plicant
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Name JACQUES CONSTRUCTION jJOTN) 9 _GILT&6-4 W) ;
Addr. 67 RIDGE ROAD Qct�Y�x.,,,JMJ
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SOUTH WINDSOR CL:.0807$
Phone No. (860)432-1823 ik
The
Drain
Layer 5s`"
Y 9n< 1'4i A, siim:�:t: <M �":lr�:..]�> c�rise ` ::r:sued by the
state an
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by a
Y g r<.. tz -. - .. �2:.. :they"''te'rms�'"and c6Ys '' t,4lti in the
attached 'Conditions >All'<:.work:; h`a'T'1:-><
of South
Windsor standards,
a dards, a17. OSI;A<' `::u 'rem.'>"'8`s ?:: at a'`1ied::>.: o:<` i
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Issued BY �r ��I" title::' ,- Gn1
----------------- -- _ :._ ----- -----------
Date Inspecte ______ Ins�'ec£ed By
TOWN OF SOUTH WINDSOR
SANITA.RY.' -, SEWE.R LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS Yr .
STREET .: yt-k-1 d-�
SUBDIVISION:
NORTH ARROW
i t ' ¢
..mow
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CONTRACTOR (PRINT)_ NAME OF CTOR'S SUPERVI R (PRINT)
STREET AD RESS Cl SIG E
DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
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:
Name of Firm: -Phone:
Address.of Firm: '
TYPE OF WORK:
Lay House Drain Repair House Drain
Lay Main _ Lay.ateraf for Commercial/Industrial
Building of acres
Connection will be made with S'
Existlng Water Supply: Public Water Well
Proposed Start Date -
. Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WTTH'TOWN.OF SOUTH WINDSOR STANDARDS
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit-is to be issued to 5�� -c
Layer's License No. �. cJ the holder of Drain
will be issued,a Only holders of P-1, P-7.or W-9 licenses
permit. PERMIT WI EXPIRE THIRTY(30),DAYS AFTER
DATE OF ISSUANCE. The undersigned Drain Layer.hereby agrees to-ail the terms
-and conditions set forth in the permit and attached thereto.
Town Street Excavation Permit No. Applicant has received
and/or ConnDOT Permit No.
CBYD No.
Signed: _
n rain Layer
Print Name:_ f0
� s'
fi, �zCcZu �
L' � -
Date:
standard F0rms\Pem61ts\APPUCA710N FOR DRAIN LAYERS PERMIr.doc
TOWN OF SOUTH ANDSOR
SANITARY SEWER LATERAL - FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS ` `
STREET V;a`{
SUBDIVISION: Enn Q&A 0
NORTH ARROW
JL
:T-T
CONTRACTOR (PRINT) NAME OF NTRACTOR'S SU RVISOR (PRINT)
N le
59 _
P- -
STREET ADDRESS SIGRty
r nr1 WiQ owl G . 5 DATE
TOWN STATE ZIP INSPECT BY TOWN
C%oa� L - ( DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER