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HomeMy WebLinkAboutDrain Layers Permit 95 Gilbert Lane i TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. Contractor JMJ CONSTRUCTION CO. Location Address 658 ELLINGTON ROAD Type Work N SAN LAT SOUTH WINDSOR CT 06074 P,hone, No. (860)528-7889 I Date Insp Needed �7 46 XZ—c / i1 � ©ate J ns p,. o?zo,/ Time Insp Needed 4/1-6 Inspected Byio 1`,d { Work in Progress <SZ& } Input Date P6firhit No. , 7310 Town of South Windsor, CT Permit Date 07/11/2001 Drain Layer Permit Expiration Dhtle 08/10/2001 Descrip. CK 10903 $775 .00 10904 183 . 33 10907 121 . 67 Applicant Location Y Name JMJ CONSTRUCTION CO. Addr. 0095 GILBERT LANE Addr. 658 ELLINGTON ROAD � C�wner`CLARK REALTY INC SOUTH -WINDSOR CT (3f1 Phone No. (860)528-7889 �<< The Drain Layer asoi`onrad this po it his Ya1,, d license issued by the state and hereby agrees _to- t1 he, terme ,and 'oon T`tions set forth in the attached 'Conditions' : '. 11 Ar`k shad"1 be .:fin ap rdance with Town of South Windsor standards, all O$HA` q iri�Irent6 sand the attached conditions. f. Issued BY Inspected Date Inspected By .� i% 77/0 • _ 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: Lot #� Street No. reet Name Premises owned by: e r.,r s 4' C . Name of Firm: Phone: Address of Firm: ;� � � 12r'7y� Aid �� TYPE OF WORK: Lay House Drain ; Repair House Drain Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with5:pp� 3 S Existing Water Supply: Public Water I Well Proposed Start Date 7 Estimated time for completion lb.*v ALL WORK TO BE IN ACC RDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS, ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT Permit is to be issued to v the holder of Drain Layer's License No. 2dtc 3® Only holders of P1 or P7 Licenses will.be issued a permit. PERMIT WILL EXPI E 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. rint Name:6Licens �Xr Date: — (,/ -7 Standard Forms\P/rmi&,WPPLICAMN FOR DRAIN LAYERS PERMIT.doc. - TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: 0716/0/ BUILDING ADDRESS : 67- 7 STREET SUBDIVISION: NORTH ARROW i f+ 1 1 , T 1 i r._ t._. . ._ _ -------- Si ' Fer�!✓Cb i '22: i -._ 7 ._ I— - - a _ ------ t ' -4 __--;__ i _ 4 ! i ! r CONT TOR (PRINT) NAME OF CONTRACTOR SUP VISOR (PR STREET ADDRESS �� SIG ATUR - -- o DATE TOWWfN- STATE ZIP INSPECTED BY TOWN DATE TELEPHONE NUMBER WHITE TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL 'FIELD LOCATION DATE OF CONSTRUCTION: 7` �2 ' BUILDING ADDRESS : STREET 7 F 6;,4-Af.1� SUBDIVISION: ��h NORTH ARROW f j E -4- 3 � iA ' CONTRACTOR (PRINT) NAME Of CONTRACTOR'S SUPERVISOR (PRINT) STREET ADDRESS SIGNATU E .�07-A DATE - -TOWN - - - STATE ZIP INSPECTED BY TOWN FI A DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER