HomeMy WebLinkAboutDrain Layers Permit 45 Gilbert Lane � I
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Pdrmit-No. 7259 Contractor JACQUES CONSTRUCTION (JOHN)
Location 0045 GILBERT LANE Address 67 RIDGE ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
Phone No. (860)432-1823
Date I nsp Needed (4111 CAI Date I nsp.
Time Insp NeededT
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own ot South -w1hosor ,
®rm1: o. Drain Layer Permit
Per%it Date 04/10/2001,
E ]yrat-ion Date 05/10/2001
Z(5 :cri"p: USER FEE PAID CK#10673
- `; Location
Applicant
Name JACQUES CONSTRUCTION (JOHN)_,
Addr. 0045 GILBERT LANE
Addy. 67 RIDGE ROAD ' CLARK REALTY INC
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SOUTH WINDSOR CT 0074 x
Phone No. (860)432-1823
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The Drain Layer aseg�ed bh 'et" � has a 'valid license issued by the
state and hereby agre�ea t��` ll Kth� " tee end °�ona1' 'iOns set forth in the
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attached 'Conditions`,. ` A I r,Wyk sl at 1 n �c � cl With Town of south
Windsor standards, af-j OSF+� r6qulremerb and the tt ched conditions.
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Issued By
Date Inspected `�—
y APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
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Location of proposed work: 1-6 C � la nJ(L Lot # D
Street No. Street Name
Premises owned by:
Name of Firm: Phone:
Address of Firm: g G 5
TYPE OF WORK:
Lay House Drain 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 Date Z14401Estimated 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 h4 L "'q the holder of Drain
Layer's License No. Dotg� Oyfly holders of P1 or P7 licenses will be
issued a permit. PERMIT WILL EXPIRE HIRTY (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: ��
Lice d n Layer
Date: 41110 D
Standard For Zper iits�APPLICATION FOR DRAIN LAYERS PERMIT.doc
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: T/ - ' /�- - 6 /
BUILDING ADDRESS ` o
STREET
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CONTRACTOR (PRINT) NAME F CONTRACTOR'S UPERVISOR (PRINT)
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TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER