HomeMy WebLinkAboutDrain Layers Permit 12 Gilbert Lane q
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7150 Contractor JMJ CONSTRUCTION CO.
Location 0012 GILBERT LANE Address 658 ELLINGTON ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
Phone No. (860)528-7889
Date Insp Needed )-`(1 ste ze6
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Permit No. 7150 Town of South Windsor, CT
Permit Date 05/22/2000 Drain Layer Permit
Expiration Date 06/21/2000
Descrip: PRO RATED FEE - $16 . 25 CASH
Applicant Locatio
n
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Name JMJ CONSTRUCTION CO. Addr. 0012 GILBERT LANE
Addr. 658 ELLINGTON ROAD ner, ,CLARK REALTY INC l
SOUTH WINDSOR CT Ot14 i
j Phone No. (860)528-7889 ;
The Drain Layer ass'i ne, h.i s Y � t _ perr��t�t has a �,ai' d license issued by the �
state and hereby agree t,6 ajf tie te-,r - .and condi ti°orhs set forth in the
attached 'Conditions',,., AI'l rk sh41 It, be:An accordance with Town of South
Windsor standards, a11` 0$HA requirements, and, :t.he attached conditions.
Issued By P�, NA Title Yho�£c'.t F1.)(_,1A)M
Date Inspected 4 Inspected, 8
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: a66`349
Address of Firm: l
TYPE OF WORK:
Lay House Drain V Repair House Drain ;
Lay Main Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water Well
Proposed Start Date0�149ld 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 e holder of Drain
Layer's License No. :HIRTY
y holders of P1 or P7 licenses will be
issued a permit. PERMIT WILL EXPIRE (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: Le-"�' rint Name: VO ' 0 Jq
ice sed br# Lay
Date: a D
Standard Forms\Permits\ PPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS :
STREET : �'�` L 4z;r V%..,�
-�- SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS S TUR
DATE
TOWN STATE ZIP INSPECTED BY TOWN
� /�li t�/�Cj' c i1/ � i l�ri' U DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER