HomeMy WebLinkAboutDrain Layers Permit 10 Elmore Way TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7148 Contractor JMJ CONSTRUCTION CO.
Location 0010 ELMORE WAY Address 658 ELLINGTON ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
Phone �No. (860)528-7889
Date Insp Needed - Date -Insp
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Time Insp Needed Ti' Insp ® ��6
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Permit NLo. 7148 Town of South Windsor, CT
Permit Date 05/22/2000 Drain Layer Permit j
Expiration Date 06/21/2000 j
Descrip: PRO RATED FEE - $16 . 25 CASH
Applicant Location
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Name JMJ CONSTRUCTION CO. Addr O010 ELMORE WAY I!
Addr. 658 ELLINGTON ROAD owner CLAR.K REALTY INC
SOUTH WINDSOR CT 0i474
Phone No. (860)528-7889 ,11 I
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The Drain Layer ass`i gnec! this Rprmft has `a va11 d license issued by the
state and hereby agreas ,ta; ,all the tor' and G:o�d tions set forth in the
attached 'Conditions'.:.. Al 1� �wtirk shA 1 . be,-"'I n acco'dance with Town of South
Windsor standards, all OSl-kA r�quiCm®nts, and t�?O at conditions.
Issued BY `�` � iJA f True
Date Inspected o Inspected ,By �� 6
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: Lot #�
St eet No. Street Name
Premises owned by: �'it In
Name of Firm: _ Phone: a 2-Clo -�
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
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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 T czl� the holder of Drain
Layer's License No. ;).09g je) Only holders of P1 or P7 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: Print Name:,
Licen D Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS �L
STREET
-�- SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS IGOTURE
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TOWN STATE ZIP INSPECTED BY TOWN
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TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS _ Lvr X72
STREET
�-� SUBDIVISION:
NORTH ARROW
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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
S"1p 1 DATE
TELEPHONE; NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER