HomeMy WebLinkAboutDrain Layers Permit 170 Commerce Way TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7004 Contractor GERBER CONSTRUCTION CO
Location 0170 COMMERCE WAY Address 616 DART HILL ROAD
Type Work NEW SAN LAT VERNON CT 06066
Phone No. (860)875-6684 �I
Date Insp Needed
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Time Insp Needed
3 I + F
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Input -1 Date 711 ifs I
Por�jt, No. Mown of South Windsor, CT
Permit Date 06/16J 9 Drain Layer Permit
Expiration Date 0 16 999
Descr p:
Applicant Location
Name GERBER CONSTRUCTION CO , Ad�fr.=< �#,70 COMMERCE WAY
Addr. 616 DART HILL ROAD ' `� wnerOtRCE WAY ASSOCIATES LLC
VERNON CT t7Qi6 �� ` � ��
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Phone No. (860 )875-6684
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The Drain Layer as(sAa-,gr �� s t ��, has � 4� �1�cense issued by the
state and hereby agr t ot the.-- e ri ,Nand d s set forth in the
attached 'Cond i t i ons'I,. A A -irk h "` n aqs }��I nr. with Town of South
Windsor standards, aIOSe2U "£1Mi®ht; t7d� ached conditions
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Issued By F_-
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Date Inspected �y2_ ' sReY
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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: // G' l�0 _
p p / �'1�.G-c.e� Lot
�Street Now. ,g Street Name
Premises owned by: /`"l /
Name of Firm: � Phone: T���y
Address of Firm:__
TYPE OF WORK: f
Lay House Drain ; Repair House Drain
Lay Main Lay Lateral for Commercial/Industrial
Building of acres
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Connection will be .made with
Proposed Start Date - 7,7 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 l- ,7%-, the ho
lder of Drain
Layer's License No. � Only 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; ahi�rrfi+`
Licensed Drain Layer
Date
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Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS . 70 �a�► << %
STREET
SUBDIVISION:
0 :
NORTH ARROW 311
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CONTRACTOR (PRINT) NAME 07 TRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNA
UZ 5 7 c� DATE
TOWN STATE ZIP IN P T WN
o — S�-G6 `f DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER