HomeMy WebLinkAboutDrain Layers Permit 25 French Lane Permit No. 7122 Contractor JACQUES CONSTRUCTION (JOHN)
Location 0025 FRENCH LANE Address 67 RIDGE ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
Phone No. (860)432-1823
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Permit No. 7122 Town of South Windsor, CT
Epp irtttion ,Date 04/12/2000
Des, ri`p: USER FEE PAID
Applicant Location
Name JJACQUES CONSTRUCTION (JOHN) Addr. 0025 FRENCH LANE
Addr. 67 RIDGE ROAD Owner CLARK REALTY INC
SOUTH WINDSOR CT 0607;4 .
Phone No. (860)432-1823
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The Drain Layer ass5}9becf .a canse issued by the
state and hereby agreeio ns set forth in the
attached 'Conditions'.. Ali e wrt sib 1Tf t n ` ccod°ace with Town of South
Windsor standards, a 1 1 43St�JA r� (u ►rats;, anti # attached conditions.
Issued Bytom-RN1 � - 2.
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'7-1 "103 Town of South Windsor,.. CT
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:_ �r Lot # 7
Street No. Street Name
Premises owned by:
Name of Firm: Phone:
Address of Firm: S8 �►`� �o,� �{/
TYPE OF WORK:
Lay House Drain • i Repair House Dra
in
an ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water Well
Proposed Start Dat ✓� dv 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 tou��e5 tT/ C the holder of Drain
Layer's License No. j 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:-9 Print Name: � �
Lic ed rain Layer
Date: / O�
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS -7
STREET : 25' Gw ��►�
-�- SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONT CTOR'S SUPERVISOR (PRI
STREET ADDRESS SIG R
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TOWN _ STATE ZIP INSPECTEIY TOWN
8(ao• ZSZ-o 2.8 DATE
TELEPHONE NUMBER y4-
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: ` 9'o,
BUILDING ADDRESS 0.,* .7 7
STREET
SUBDIVISION: AO eft5ih
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NORTH ARROW
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CONTRACTOR (PRINT) NAME OF ONTRACTOR'S SUPERVISOR (PRINT)
7 S— C& ,-i"e a r�J j�wz 6 `2—91
STREET ADDRESS SIGNATU
s'o-iokA O 6!!7y DATE
TOWN STATE ZIP INSPECTED BY TOWN
�6 0 S-2�' r;2 r2 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER