Loading...
HomeMy WebLinkAboutDrain Layers Permit 75 Gilbert Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No.INEW Contractor JACQUES CONSTRUCTION (JOHN) Location Address 67 RIDGE ROAD Type Work SAN LATW SOUTH WINDSOR CT 06074 Phone No. (860)432-1823 Date Insp Needed � 1 ©� Qet e. Ins 03 O/ t R Time Insp Needed p;a-d- i Inspected By E/Jt tom= j Work- in Progress Z4 a vLc,er j Cc c�-ay - I.�Er G �' �,0•,�� "]�1P�r �Gv�� �y� Input Date Perroift_-No. 7319 Town of South Windsor, CT Perm°'it_:"gate 07/27/2001 Drain Layer Permit Expiation Date 08/26/2001 Descrtp: CK NOS. 10918/919/926/928-` Applicant Location Name JACQUES CONSTRUCTION (JOHN)� AddO. ,0075 GILBERT LANE Addr. 67 RIDGE ROAD t net:CLAR)C REALTY INC SOUTH WINDSOR CT 0644 Phone No. (860")432-1823 The Drain Layer as �,gn04, :this p4 4f, has , -VA license issued by the state and hereby agrees=to ., l .`the t Cat end `scan i-tti Ens set forth in the attached 'Conditions' � �A1 o' k sh ben ac4rdan with Town of South Windsor standards, ai `i n0SN�3._r64-ui � Ct '.send the atiached conditions. Issued By - Date Inspected c�i` ` nepeatYeci y 751 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: �.� ��e Lot # Street No. Street Name Premises owned by: Name of Firm: Phone: S a "06 ?- Address of Firm: rv� 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 a Ol Estimated time for completionIbly-JI ALL WORK TO BE IN CCO DANCE WITH TOWN OF SOUTH WINDSOR STANDARDS, ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT Permit is to be issued to ZRCCaV61S the holder of Drain `Layer's License No. O CEO a0 . Only/holders 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: License Drai ayer Date: Standard Forms 4ermits\APPLI/CATION FOR DRAIN LAYERS PERMIT.doc J TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS : Lc STREET : SUBDIVISION: P'" ^4► NORTH ARROW 1 �I � I + { o i /! I t on ' - - - erest 9 a�•�1r � D�i6'�"4 0 ; , d , { I ; 4 r { , 71- { { CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERV OR (PRINT) STREET iiADDRESS IGNATURE S. ^h��Y _ � � ��� l �f 9�2/0/ DATE TOWN STATE ZIP INSPECTED BY TOWN 50 d /�� DATE \ TELEPHONE NUMBER Ga \WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: ` 0 0: BUILDING ADDRESS STREET : Lem G 16 r . SUBDIVISION: NORTH ARROW lip _ i __ 1 CONTRACTOR (PRINT) NAME 0 CONTRACTOR'S SUPERVISOR (PRINT) STREET ADDRESS SIGNATURE Jc%)1,t We�VJck 07' O 6 U"79 DATE TOWN STATE ZIP INSPECTED BY TOWN �� U •S`�� �Zf—� DATE TELEPHONE NUMBER WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER