HomeMy WebLinkAboutDrain Layers Permit 513 Deming Street a TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7443 Contractor JACQUES CONSTRUCTION (JOHN)
Location AlAddress 67 RIDGE ROAD
Type Work NEW A . L SOUTH WINDSOR CT 06074
No. (860 )432-1823
Date Insp Needed s o
Time Insp Needed
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Permft.N®. 7443 Town of South Windsor, CT
Permit Date 06%10/2002 Drain Layer Permit
Expiration Date 07/10/2002
Descr_i_pr CK 11647 $17 12° 11636 $875 .00
Applicant Location
Name JACQUES CONSTRUCTION 011 1 DEMING ST
Addr. 67 RIDGE ROAD L REALTY
SOUTH WINDSOR CT
Phone No. (860)432-1823
The Drain Layer a s asry 1 cense issued by the
state and hereby agr ess--� s�- h nd do s set forth in the
attached 'Conditions' . 1 a with Town of South
Windsor standards, al , q ached conditions.
Issued By
Date Inspected 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 $25.00
Location of proposed work: 'e Lot #
Street No. Street Nam
Premises owned by: _�
Name of Firm: Phone:
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
Existing Water Supply: Public Water Well
Proposed Start Date Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTAC ED TO THE PERMIT
Permit is to be issued to -L v�S the holder of Drain
Layer's License No. 3 . Only holders of P-1 or P7 licenses will be
issued a permit. PERMIT WILL EXPIRE THI TY (30) DAYS AFrER 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:
Licens r Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: �� h
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BUILDING ADDRESS
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SUBDIVISION: VIC 4N I-ym fI S tYs
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS _ SIGNATURE
DATE
TOWN / STATE ZIP INSPECTED BY TOWN
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a v _ Lo) DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER