HomeMy WebLinkAboutDrain Layers Permit 61 Gilbert Lane I
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7250 Contractor JACQUES CONSTRUCTION (JOHN)
Location 0061 GILBERT LANE Address 67 RIDGE ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
PhineN . (860)432-1823
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Date Insp Needed 61/�u gate Insp' �� d O /
Time Insp Needed Time Insp
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Inspected By �n �
Work in Progress
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Input Date
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0er4it No. 7250 Town of South Windsor, CT
Permit- Date 03/21 /2001 Drain Layer Permit
Expiration Date 04/20/2001
Descrip: LOT 82 CK10610 775 .00 CK10611 49 . 97
Applicant Location
Name JACQUES CONSTRUCTION 014N) Addr: 00811 GILBERT LANE
Addr. 67 RIDGE ROAD fiWher, -CL/ tK REALTY INC
SOUTH WINDSOR CT. &6,j
Phone No. (860)432-1823¢` ' f
The Drain Layer a � n £t i s it t. has � �s� i d, �l cense issued by the
state and hereby agrees` t � � theem sand + aiditio s set forth in the
attached 'Conditions' ,.-All ► +r ei 1 ,ian acordnc2 with Town of South
Windsor standards, al 3 A: requii erents, af7d the. attached conditions.
Issued By
Date Inspected �� �� O� xnspecte;d By -- --
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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: 6/ �✓`�:r^X Lot # S)L,
Street No. Street Name
Premises owned by:�,� Cd ,
Name of Firm: Phone:
of Firm:
Address �
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 D P
Existing Water Supply: Public Water Well
Proposed Start Date l o/ Estimated time for completion p
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
A
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to t,6 Le—S ✓ l4e holder of Drain
Layer's License No. ';�Qq8 30 . Only Iders of P1 or P7 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.
CBYD No.
Signed.
Print Name:
Licen d D 'n Layer
Date:
Standard For 4sPermits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS 49
STREET : Cal 671/4 e-Il 5�/
SUBDIVISION: ►
NORTH ARROW
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CONTRACTOR (PRINT) NAME F CONT CTOR'S OERVISOR (PRINT)
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ST:'R-E6 ADDRESS SIGNATURE
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TOWN / STATE ZIP INSPECTED BY TOWN
(� ►�SL- O b �� DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET
SUBDIVISION: 0� ih� h��/! ftGrP.1
NORTH ARROW
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CONTRACTOR (PRINT) NAME OFCONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS SIGNATU
fo I,rA pfn✓fo'1• 60 G b 7Y DATE
TOWN STATE ZIP INSPECTED BY TOWN
52 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER