HomeMy WebLinkAboutDrain Layers Permit 575 Deming Street TOV:: CF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7688 :<.
Contra for JACQUES«-CONSTRUCTION (JOHN)
Location 0575 DEMING STREET
A"ddre. g 67 ;RIDGE RO`AFJ.
Type Work NEW SAN LAT
SQ[I�H WINDSOR CT 06074
Phone; No (8.£4)432 1823
Date Insp Needed �r ,�
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Permit No. 7688 Town of South Windsor, CT
Permit Date 10/31/2003 Drain Layer Permit 1
Expiration Date 11/30/2003
Descrip: USER FEE PAID CK#12670.
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Applicant Lpcdt'i.:on
Name JACQUES CONSTRU 'T'CION W HN7 A4 d 0 : 5 11EMING STREET
Addr. 67 RIDGE ROAD OWn s:..CLARK _y3iE4LTY. INC
SOUTH WINDSOR C`f- 06074
Phone No. (860)432-1823
The Drain Layer assigned-tkas permit his a valid 7cense issuied by the
state and hereby agrees to all ahe term& and condatictns set` forth in the
attached 'Conditions All work stria"] ks sh i,ord*AnCe with Town of South
Windsor standards, alb; OSHA requiz &ifthe. attached -conditions.
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Issued By --------
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Date Inspected ------ Inspected By _--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 $60.00
Location of proposed work: ,- b
Lot # 1 t�
Street No. Street r9me
Premises owned by:_ •Jt
Name of Firm: Phone: ^? Q�
Address-of Firm: S^c" �C d
.TYPE OF WORK:
Lay House Drain Repair House Drain
Lay Main ; Lay Lateraf for Commercia Industrial
Building of acres
Connection will be made with - S'—
Existing Water Supply: Public Water Well
Proposed Start Date /. 31 493 Estimated time for completion
ALL WORK TO BE IN �CCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to -Jo- the holder of Drain
Layer's License No. O fig ® Onl holders of P-1, P-7 or W-9 licenses
will be issued a permit. PERMIT WILL EXPIRE THIRTY(30)°DAYS AFTER
DATE OF ISSUANCE. The undersigned Drain Layer hereby agrees to all the terms
and conditions set forth in the permit and attached thereto. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No.
Signed: �
g Print Name: jX t p, C G2
Licens r ayer
Date:
Standard; rms\P mits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING'° ADDRESS : . .L� � l$
STREET D ,v„'� tr ec
SUBDIVISION: to5�� f" es
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CONTRACTOR (PRINT) NAM OF CONTRACTORS SUPER-VISOR (PRINT)
S REET ADDRESS p� I TURE
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TOWN STATE ZIP INSPECTED BY TOWN
DATE
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TELEPHONE WUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER