HomeMy WebLinkAboutDrain Layers Permit 2 Elmore Way 1 g
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7318
Contractor JACQUES CONSTRUCTION (JOHN)
Location 00ELMORE WAY Address 67 RIDGE ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
Phone-,No. (860)432-1823
Date Insp Needed Qa6 �U ,dog p
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Permit ISo. 7318 Town of South Windsor, CT
Permit"bate' 07/27/2001
Expiration Date 08/26/2001
Descrip: CK NOS. 10916/917/925/927
Applicant Location
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Name JACQUES CONSTRUCTION (JOHN) Add
A d d r � ;Owner', CLARK REALTY INC
SOUTH WINDSOR CT 060,74 3
Phone No. (860)432-1823
The Drain Layer assigned thrtes y Y � pei�m�t 1'ias � �a��d license issued b the
state and hereby agrees. to, 1 _ the termt and` con,citibns * set forth in the
attached 'Conditions' : =A11 " Qrk shall,',
be jn accordance with Town of South
Windsor standards, all, re O$HA., quirements, °and 'the attached conditions.
Issued BY Title
Date Inspected l0 4� Inspected' ByZ
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: O✓-Zff 1,4,IHX Lot # �l
Street No. Street Na
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 IIZ>14 .
ALL WORK TO BE IN ACCO DANCE WITH TOWN OF SOUTH WINDSOR S4NDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to the holder of Drain
Layer's License No. cQOKC3e niy holders of P1 or P7 licenses will be
issued a permit. PERMIT WILL E*PI . 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.
7 -Print Name:
_ Signed_:. . .. _ - -_ -
Li en Dr aver
Date:
Standard For s\Permits PLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS 71
STREET
SUBDIVISION:
NORTH ARROW � ' e I i7-&V 16�i
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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