HomeMy WebLinkAboutDrain Layers Permit 5 Gilbert Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
)ermit No. 6973 Contractor JMJ CONSTRUCTION CO.
_ocation 5 GILBERT LN Address 658 ELLINGTON ROAD
"ype Work NEW SAN LAT _€ SOUTH WINDSOR CT 06074
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Phone 'No. (860)528-7889
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Input Date
' emitVo: 6973 Town of South Windsor, CT
4rml� D*fie 04/20/1999 Drain Layer Permit
.Expiration Date 05/20/1999
Descrip: CK 8927 $775 . 00 CK 8928 $32 . 50
Applicant Location
Name JMJ CONSTRUCTION CO. f Adr: 5 - LBERT LN
Addr. 658 ELLINGTON ROADAK, REALTY
SOUTH WINDSOR CT /06V7,*
Phone No (860)528-7889 a '
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The Drain Layer a* s� has � a cense issued by the
state and hereby agr - t nd �10 s set forth in the
attached 'Conditions with Town of South
Windsor standards, al qe ched conditions.
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Issued By
Date. Inspected
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{ 6 773
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: 61 14C Lot #
Street No. Street Name
Premises owned by:
Name of Firm: !S 64-LM-X — Phone:
Address of Firm: I^ 21V,�l 13J
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with S 3
Proposed Start Date ?-O`99 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 J :1L GS J 1'TCV54he holder of Drain
Layer's License No. 30 , . 04 holders 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:
Lic ed in Layer
Date: C2
Standard Forrns\Perrnits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
r TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: . P
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BUILDING ADDRESS D
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SUBDIVISION: ► S �
NORTH ARROW
701
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CONTRACTOR (PRINT) NAM OF CONTRACTOR'S SUPERVISOR ( iNT)
STREET ADDRESS ` SIGNATURE
e �✓ O Y" C / Q GCS 17 46 Lop� DATE
TOWN - r_ S'A -SIP __ INSPE BY TOWN
- 0 �' �� DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER