HomeMy WebLinkAboutDrain Layers Permit 11 Elmore WayI
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7085 Contractor JMJ CONSTRUCTION CO.
Location 0011 ELMORE WAY Address 658 ELLINGTON ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
Phbhe.,,No. (860)528-7889 j
Date Insp Needed 11 1161 � �t�< Ihs
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Input, Date
Pe-OwEr Vo. 7085 'Town of South Windsor, CT
.Permit -Date 11/15/1999 Drain Layer Permit
Expiration Date 12/15/1999
Descrip:
Applicant Location
Name JMJ CONSTRUCTION CO. `Addr.: 011 ELMORE WAY
Addr. 658 ELLINGTON ROAD Qwnsr CLARK REALTY INC
SOUTH WINDSOR CT40 74
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Phone No. (860)528-7889r
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The Drain Layer ass�ic�r�6d thes p�rlo t has � 1 ci 1. cense issued by the
state and hereby agrde � r tF� t�rtri and o d�ti-6 s set forth in the
attached 'Conditions' .- A I Birk s� � n a oJ.
rdnc with Town of South
Windsor standards, ai 1 b attached conditions.
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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 $25.00
Location of proposed work: �/-'e of # 7
Street No. Street Name
Premises owned by:
Name of Firm: Phone: (off
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
Proposed Start Date 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 C�f>�S �der
(ne hold r
e of DramLayer's License No. �W � . 0 hols 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: Print Name: J �VIeue 5
L' se erain Layer
-`
--- ------ : ....Date: -- 1
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
= TOWN OF SO
UTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 99
BUILDING ADDRESS :
STREET :
+ SUBDIVISION: -e 11 Lim
NORTH ARROW
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CONTRACTOR (PRINT) NAME QF ONTRACTOR'S SU RVISOR (PRINT)
14
STREET ADDRESS - ATU _
Q c ok2 Z , /d 9 f DATE
-TOWN STATE ZIP I PECTE BY T WN - -
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: G.. 2 y 9
BUILDING ADDRESS -t At '7
STREET
SUBDIVISION: )Vogl .Es roA-_r
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF C TRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
5,01 LIM C��h e%r�,r cgT ���>y DATE
TOWN STATE ZIP INSPECTED BY TOWN
G j`-z S",2 DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER