HomeMy WebLinkAboutDrain Layers Permit 80 Gilbert Lane * TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7268 Contractor JACQUES CONSTRUCTION (JOHN)
Location 0080 GILBERT LANE Address 67 RIDGE ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074 I
Phone No. (860)432-1823
Date Insp Needed F75� �d
fiat Insp. ,:� V, jo o,/
Time Insp NeededT,
ne . irisp
Inspected By
Work in Progress
4 {
b 3
. 1
Input Date
Permit No. 7268 town of South Windsor, CT
Pa, * Date 04/25/2001 Drain Layer Permit
Expation Date 05/25/2001
Descrip:
Applicant Location
Name JACQUES CONSTRUCTION (JOHN")� A dr. `U080 GILBERT LANE
Addr . 67 RIDGE ROAD OWner" CLARK REALTY INC
SOUTH WINDSOR CT7� 34 `'
Phone No. (860 )432-1823
The Drain Layer, assigned than pem�t . ba$ ,a valid license issued by the
state and hereby agr0e€4i to, ' 1 the a and cand7 ti€�t�s set forth in the
attached 'Conditions'-.� , A I , MOr 'sha) 1 ie. i n a cb;rd nc with Town of South
Windsor stan ards , a 11 OS; r.equ t" 1r1ef1f,S, and the attached conditions.
Issued B
y .. E
Inspected 'BY -�
Date Inspec ed ---�--
APPLICATION FOR DRAIN LAYER PERMIT (G'
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE,$25.00
Sac
Location of proposed work: ?6) GilLot # 1?L
Street No. Street Name
Premises owned by:�J
Name of Firm: Phone:
Address of Firm: S S Q/
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 y O 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 o� the holder of Drain
Layer's License No. 22�.3l> . 0 ly 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: ��h �4a �cc S
Lice d D Layer
A
Date: D
Standard rms\Pe mits\APPLICA7I0N FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 3 r U U
BUILDING ADDRESS
STREET
SUBDIVISION: ��fi %�►� ��-�ffl�>`C'f
NORTH ARROW
------
A j} _
tqI
co
� I I � I ; � ► I ! f i 1 � E I
i 7 --I--- --�
CONTRACTOR (PRINT) NAME 0 CONTRACTOR'S SUPERVISOR (PRINT)
7f- &A�- )J�
STREET ADDRESS SIGNATU
s1/l4 u�ih•/fvi� C�" 0 6 tl 7 Y DATE
TOWN STATE ZIP INSPECTED BY TOWN
r-! D S- �' f�- S DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER