HomeMy WebLinkAboutDrain Layers Permit 10 French Lane Y
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7149 Contractor JMJ CONSTRUCTION CO.
Location 0010 FRENCH LANE Address 658 ELLINGTON ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
Ph6ne .No. (860)528-7889
Date Insp Needed � Qate ' Insp.
Time Insp Needed T €me InsR l`�• j
Inspected By
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Permit- No. 7149 Town of South Windsor, CT
Permi,C Date 05/22/2000 Drain Layer Permit
Expiration Date 06/21/2000
Descrip: PRO RATED FEE - $16 . 25 CASH
Applicant Location
Name JMJ CONSTRUCTION CO. Addr., 000 FRENCH LANE
Addr .. 658 ELLINGTON ROAD ►pr CLARK REALTY INC
SOUTH WINDSOR CT ;0il} 4
Phone No. (860)528-7889
The Drain Layer ads°ignple` .this pr tt ;has a v�! 7 d- ,l cense issued by the
state and hereby agr4d_6,'t �-4,VT the terms; and cc r ely tions set forth in the
attached 'Conditions',., ,A l ,Wgrk h b i n ad�brd4nce with Town of South
Windsor standards_ , a 1 QSHA recjui r®fin , =end labs' a:ttched conditions.
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Issued ByCb ' .-. �. SfcGjAr,INE
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Date Inspected --�7L v4r►sQi;ed 8y
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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: iI - Lot #
Stre t No. Street Name
Premises owned by: -:
Name of Firm: Phone: o�
Address of Firm: �C
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with R 3S
Existing Water Supply: Public Water Well
Proposed Start Date Estimated time for completion /eL
ALL WQRK 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 J� Gc2_ v ✓ the holder of Drain
Layer's License No. (Aly 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: kV-J k CC9J 19�
J'Li ense rain yer
Date: �- D
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH ANDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS G URE
DATE
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: �^ " z 9,9
BUILDING ADDRESS Z ° T yZ
STREET : Ft-e,7CA LCAh V
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CONTRACTOR (PRINT) NAME OF ONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS SIGNATURE
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TOWN STATE ZIP INSPECTED BY TOWN
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TELEPHONE. NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER