HomeMy WebLinkAboutDrain Layers Permit 19 Elmore Way (2) • � ' TOWN OF SOUTH WINDSOR INSPECTION REPORT
Ke -
Permit Nt� 7f67 Contractor JACQUES CONSTRUCTION kJOHN)
Locations 0019 ELMORE WAY Address 67 RIDGE ROAD '
Type Work NEW SAN, L'AT SOUTH WINDSOR CT 06074
Poi , No. (860)432-1823
Date Insp Needed hs �
Time Insp Needed
�`�rrte Insp
Inspected By jg
d
Sy e
Work in Progress
T
.
Input - Date
t
Permit No. 7167 Town of South Windsor, CT
Permit Date 07/14/2000 Drain Layer Permit
Expiration Date 08/13/2000
Descrip:
Applicant Location
Name JACQUES CONSTRUCTION (J'O 'Adfr. Q19 ELMORE WAY
Addr. 67 RIDGE ROADner << LAfK REALTY INC
j
SOUTH WINDSOR CT��00 4, z
Phone No. (860)432-1823 _
The Drain Layer as£s`:ig perit has a ual d , 1 i cerise issued by the
state and hereby agrees ' c� i1 t ® : �r - t andai�11 ti,os set forth in the
attached 'Conditions' s khi �� �n ad�np with Town of South
Windsor standard al`7 OtA ' ettr niv , d the attached conditions.
Issued By
Date Inspects ' Inspecled By
n
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 # T�
St eet No. Street Name
Premises owned by:
Name of Firm: Phone:
Address of Firm: ell
TYPE OF WORK:
.ay House Drain ; Repair House Drain
Lay Main L
ay 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 v
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED T,Q THE PERMIT
Permit is to 6- 0� ;7XuC7o�
be issued to ...�o �Layer's License No. ' the holder of Drain
� �'Ca my holders of P1 or P7 licenses will be
issued a permit. PERMIT WILL EXPIR 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: S22Print Name:_ yta
Licens Dr ' ayer
mate:
-Standard Forms\Pe mits\APPLICATION FOR DRAIN LAYERS PERMIT.doc