HomeMy WebLinkAboutDrain Layers Permit 1665 Ellington Road a TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7021 Contractor GERBER CONSTRUCTION CO
Locat ion 1665 ELLINGTON ROAD Address 616 DART HILL ROAD
Type Work NEW SAN LAT VERNON CT 06066
Rhone No. (860)875-6684
Date Insp Needed -�.��T Qate `Insp /2_
Time Insp Needed 1me p
Inspected B
Work in Progress . �' . rV . i�.�f �.wcT �_ •rSiG' .-2-
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input Lrfk Date
Permit, 7021 Town of South Windsor, CT
' Permi`�` o to 07,12.3/1999 Drain Layer Permit
Expat pn Date 08/22/1999
Descr t `�- T%LAND BANK
77
Applicant Location
Name GERBER CONSTRUCTION C0idr.`" i665 ELLINGTON ROAD
Addr. 616 DART HILL ROAD Owned KBLLEY RICHARD S
J ..
f t
VERNON CT ;"6 ,
Phone No. (860)875-6684 F
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The Drain Layer a#atgr�dt 'this { r id t Firms }a va> i t� 'l _i cerise issued by the
state and hereby agrees 1 th,� ter anc eondti ti"ot�s set forth i n the
attached 'Conditions':. .-Aj?",.£ww"ek shy i in a C rtl iric with Town of South
Windsor standards, al'1 ;dSlA eWair�in , rand the attached conditions.
Issued By
Date Inspected /�- !� � .9 " ` Trsapepted 8y _
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7 001
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: �6 �`-"�n d� Lot #
Street No. Street Name
Premises owned by:
Name of Firm: CEe�"rrk C-eti), � Phone:
Address of Firm: b�� �! N �/ ��� ��,,�V Ju C
TYPE OF WORK:
Lay House Drain !/ • Repair House Drain—
Lay
p
Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with G 41
Proposed Start Date /`zr 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 SZ-- the holder 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: "40e c/�t
Print Name: �.
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMTT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
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CONTRACTOR (PRINT) NAM OF RACTOR'S SUPERVISOR` PRINT)
STREET ADDRESS SIGN R
1/9 ,QATE
-TOWN - '• STATE ZIP IN ECTED B TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER