HomeMy WebLinkAboutDrain Layers Permit 48 Gilbert Lane r
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7026
Contractor JMJ CONSTRUCTION CO.
Location 0048 GILBERT LANE Address 658 ELLINGTON ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
Phone No. (860)528-7889
Date Insp Needed B Date Ins
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Time Insp Needed
Inspected By
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Work in Progress
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Inut Date X1� Iti�
Perr6jt. 'No. 7026 Town of South Windsor, CT
Per`t.*t®gate 07/28/1999 Drain Layer Permit
F_xiiration Date 08/27/1999
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Applicant Location '
Name JMJ CONSTRUCTION CO. Addr. 0048 GILBERT LANE
Addr. 658 ELLINGTON ROAD Awrter LARK REALTY INC
SOUTH WINDSOR CTf64
Phone No. (860)528-7889
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The Drain Layer assnedK th�-s p �i; .hits .;aa i Cf "`l i cense issued by the
state and hereby afire t0T1'' thtm
,an set forth in the
attached 'Cond i t i ons A f k shy n ap rl4ncp with Town of South
Windsor standa s, a 1 1 SI A equ '4t118f� $, and i; attached conditions. "
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Issued By = 1
Date Inspec e r .` �6peC14t� $.Y
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR 0
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Location of proposed work:- 4146 611.1�p44 Lot
Street No. Street Name
Premises owned by:
Name of Firm: S ( Phone: �Cxo'�$
Address of Firm: �1 i .i'O✓
TYPE OF WORK:
Lay House Drai ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with S 9 34�;_
Proposed Start Date Estimated time for completion DAY
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 the holder of Drain
Layer's License No. /Only 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: "^
g Print Name: � m•T cr-a =
Li se rain Layer
- - Date: 9-5? ' 9
_- _ Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY -SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: �� I
BUILDING ADDRESS
STREET . G' t a h e
SUBDIVISIO
NORTH ARROW
77,
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COCTOR (PRINT) ,p NAM OF CONTRACTOR'S SUP RVISOR (PRINT)
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STREET ADDRESS vIG ATU
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TOWN STATE ZIP INS CTED TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEEI / DEVELOPER