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HomeMy WebLinkAboutDrain Layers Permit 899 Ellington Road I r TOWN OF SOUTH WINDSOR INSPECTION REPORT r Permit No. 8040 Cont:ra'ctor."JA-C—2:8;::..CONSTRUCTION (JOHN) Location 0899 ELLINGTON ROAD Addlres's 7 RIDJOE RO'A. Type Work NEW SAN LATpUTH WTNBSOR ''GT 06074 . Rhone No (8hfl)432 k823 ` 9 o Date Insp Needed s1z 1 G IIat. I1# 3 H f Time Insp Needed ------------- - 3ym Tys k . e �a Inspected By Work in Progress � 5 ---` -- 77, Rein— --Fw ` N © �° 3 Date— i I1 l f Permit No. 8040 Town of South Windsor, CT � Permit Date 03 20 2006 / / Drain Layer Permit Expiration Date 04/19/2006 Descrip: USER FEE CK20769PLUS 2CA6H �f Applicant `Location Name JACQUES CONS TRUOTION: (JOFf } �3 pg�9 EL.IL ON ROAD Addr. 67 RIDGE ROAD Owner JMJ QNRUCTTON ::.CO INC z SOUTH WINDSOR ., 06Q74 Phone No. (860)432-1823 iK The Drain Layer: assig-bjd ril pc 'sS'ued by the state and hereby agrees, to a]l:''the terms xxd cohdi' i©rr§ :set fo.Tth in the attached 'Condition All work 5 1.1 kd 2 a I'M.1.0Lda ice with. Town of South Windsor standards, ail DSHA'requireinantsf.' d..the attac,heff:conditions. Issued By --�� yr = itle ` ran �"--�--- —---------- Date Inspected --------------------- Inspected By --------------------------- 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: Streefi Lot # No. Street ame Premises owned by: C 0 't'�Zf Name of Firm: --- Phone: g d g Address.of Firm: .TYPE OF WORK: Lay House Drain Repair House Drain Lay Main - ; LaY Lateral-for Col/ Building of mmeraaIndustrial acres Connection will be made with . 3�` t a Existing Water Supply: Public Water - Well Proposed Start Dates D Estimated time for completion ALL WORK TO BE IN ACCORDANCE . ALL OSHA WITH TOWN OF SOUTH WINDSOR STANDARDS, REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT Permit is to be issued to :fd�k2 vas Layer's License No. d 6 3ra , Only holders of P-1the older of Drain Will be issued-a permit. PERMIT WILL EXPIRE holders r W-9 licenses DATE OF ISSUANCE. The undersigned grain Layer RTY C30)'DAYS AFTER - and conditions set forth in the Y hereby agrees to all the terms ved Town Street Excavation Permit No. it and attached thereto. and./orCopinnDOT Permit No. CBYD No. Signed: _ Lic s Print Name: rain Layer r Date. 0 Standard S\Pere'MAPPLICA-1ON FOR DRAIN LAYERS PERMIT.doc f TOWN OF - SOUTH WINDSOR SANITARY SEWER LATERAL FIELD - LOCATION DATE OF CONSTRUCTION: 0 O BUILDING ADDRESS STREET ; 5 L SUBDIVISION: NORTH ARROW IN wep Y _ CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT) STREET ADDRESS SIGNATURE DATE TOWN STATE ZIP INSPECTED BY TOWN DATE TELEPHONE NUMBER WHITE - TOWN PINK CONTRACTOR YELLOW.- CONSULTING ENGINEER / DEVELOPER