HomeMy WebLinkAboutDrain Layers Permit 8 Gilbert Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7039 Contractor JMJ CONSTRUCTION CO.
Location 0008 GILBERT LANE Address 658 ELLINGTON ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
Phone No. (860)528-7889
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"-'Permit No. 7039 own of Sout Win sor , CT
pgrpi, t Date 08/23/1999 Drain Layer Permit
Expiration Date 09/22/1999
Descr`43: USER FEE PAID CK#09266 i
Applicant Location
Name JMJ CONSTRUCTION CO. Addr. 0008 GILBERT LANE
Addr. 658 ELLINGTON ROAD pwner, CLARK REALTY INC.
SOUTH WINDSOR CT 06,674 a
Phone No. (860 )528-7889 =.
The Drain Layer as$"j-I gn4,d this p+ rm# ; -has : a v ( 7d license issued by the i
state and hereby agrees t 7{�; th :' erm :. '�? "ions set forth i n the
attached 'Conditions" . T„ yp a 1 i n� acdnc� with Town of South
Windsor standards, a� i Q9iA requirsme }; andh attached conditions.
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I. Issued By Jr �:. Title- r G
�n - e,Otis ey
Date Inspected Z� _ P
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 #
Street No. Street Name
Premises owned by:
Name of firm: Phone:
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 5-D•R ai��
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 a holder of Drain.
Layer's License No. 3 Onl holders of P1, P7 & W9 licenses will
be issued a permit. Permit will expire thirty ( ) 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:
Licen Dr AzLayer
Date:
Standard forms\Pecmits\AP.PLICATION FOR-BRAIN LAYERS PERMrr.doc - -
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FI ELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS Za 7- ,Or-
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGN RE
Socr��8 !�^3�So ac Cam` �17
TOWN STATE ZIP INSPECTED 8Y1OWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER