HomeMy WebLinkAboutDrain Layers Permit 601 Dart Hill Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7719 Contx,a: tor` G9RB'ER:::..;gONSTRUCTION CO
Location 0601 DART HILL ROAD Address:: 1 N.-TME.G ftgVE
Type Work NEW SAN LAT E L L I N GT ON CT O'6,029
Phone :Na (-86;0) 87'S;s6684
Date Insp Needed �� Datesns
Time Insp Needed Tamp I
Inspected By -- —
Work in Progress
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Permit No. 7719 Town of South Windsor, CT
Permit Date 03/23/2004 Drain Layer Permit
Expiration Date 04/22/2004
Descrip: INSTALL SEW. LAT. Tp''HQU-E*
Applicant L<iction
Name GERBER CONSTRUCTON. CO Addy :6.: 1 �AR.T HTL� ROAD
Addr. 1 NUTMEG DRIVE Own�x GERBER EDWIN j
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ELLINGTON CT:..09029 .::
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Phone No. (860) 875-6684 --'
The Drain Layer as 1.d ieense issued by the
state and hereby agre�S"to0;1 the terms and con"di5ion - seC £Q 'th in the
attached 'Conditions' . All work sh IT .3� - k scearda wit- Town of South
Windsor standards, al'1. OSHA xcuiremns - d the attathed::eariditions.
7
Issued By Title.;' Ca
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Date Inspected { Inspecte y
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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 $60.00
Location of proposed work: b l a!I
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Lot #
Street No. Street Name
Premises owned by: bv)'A.)
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Name of Firm: CJae�t Ph7
Lens d i.� '
- �C- one:.
Address.of Firm: u4n-e �n
.TYPE OF WORK: /
Lay House Drain Repair House Drain
Lay Main
' Lay Lateral for Cornmerciai/Industrial
Building of acres
Connection will be made with 0/-
Existing Water Supply: Public Water WeILZ�L
Proposed Start Date v/- o Estimated time for completion V'J- 011
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
Layer's License No. /�� zU�ysZ a holder of Drain
. Only holders of P-1, P-7 or W-9 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: 'Ov,
Licensed Drain Layer
Date:__
3. zZ, c,y
Standard Forms\Permits\APPLICA710N FOR DRAIN LAYERS PERMIT.doc
` TOWN OF SOUTH WINDSOR
SANITARY - SEWER LATERAL 'FIELD LOCATION
DATE OF CONSTRUCTION: �' o
BUILDING ADDRESS : co
STREET . l
SUBDIVISION:
NORTH ARROW
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CONTRACTOR {PRINT) % ��� NAM OF CO RACTOR'S SUPERVISOR (PRINT)
STREET ADDRES SIGNA RE
DATE
TOWN /STATE ZIP I SPECTEI BY Tww
r9" 6 ��' C� DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER