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HomeMy WebLinkAboutDrain Layers Permit 103 Gilbert Lane P ' TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 7339 Contractor JACQUES CONSTRUCTION (JOHN) Location 0s1fT``"Llti1 Address 67 RIDGE ROAD j Type Work NEW SAN LAT SOUTH WINDSOR CT 06074 Phone= No. (860)432-1823 Date I nsp Needed —/'✓ �" date . insp, lJ1 Time Insp Needed Time Ins # r Inspected By Work in Progress �,e� G �>.w �Tan�rF � j�-c;� 0=)�. I "hnput Date o - � Per,mi,t. Ng. . 7339 Town of South Windsor, CT Permi t' Uat@''1.0/19/2001 Drain Layer Permit Expiratioyn Date 11/18/2001 Descrip: LOT 78 CK 11130 $875 .00 CK 11131 $153. 76 Applicant Location Name JACQUES CONSTRUCTION (JOHN)--: Ad¢r. ,01.03 GILBERT LANE Addr. 67 RIDGE ROAD " „Q ner CLARK REALTY INC SOUTH WINDSOR CT 060 Phone No. (860)432-1823 r The Drain Layer as$i;gn�d thYs permit ;h"as a va14d 'license issued by the state and hereby agres =to` 'the." en and co-id'iti iris set forth in the attached Cond i t i ons' l = A 1 " Wank shal 1 ,j n a6d,6edance` with Town of South Windsor standards, a1i ".0SHArequiremente and the attached conditions. Issued By Date Inspected Inspected By, -- �. r � APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL (� 1540 SULLIVAN AVENUE r SOUTH WINDSOR, CT FEE $25.00 Location of proposed work: M3 61AWY4 Lot #�_ Stfeet No. Street Name 4 Premises owned by: Name of Firm: Phone: �a�"®6a g Address of Firm: S TYPE OF WORK: Lay House Drain ; Repair House Drain ; Lay Main Lay Lateral for Commercial/Industrial Building of acres Connection will be made with 5 J 5 Existing Water Supply: Public Water Well Proposed Start Date 0 Estimated time for completion ALL WORK TO BE IN ACC RDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS, ALL OSHA REQUIREMENTS AND CONDITIONS A HED TO THE PERMIT Permit is to be issued to a holder of Drain Layer's License No. Only olders of Pi or P7 licenses will be issued a permit. PERM T WILL E E TH RTY (30) DAYS AFTER DATE OF ISSUANCE. The undersigned Dra Layer reby 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. /Z Print Name: Li se rain Layer Dat : © , Standard Fo/ms\Per4S\APPLICATI0N FOR DRAIN LAYERS PERMIT.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: / / — o 0 BUILDING ADDRESS L. o 7 STREET : 103 C11 4 e'- r L- 4 ►� SUBDIVISION: le NORTH ARROW 3 . --t J i ( i + i • • t t 1 F ' f i -1 ' .� � � + i 4 - } i. - 1 - i i j3 = i + f + ...r. /hJs ro ns"t Co, 5coe 61 e CONTRACTOR (PRINT) NAME OF CONTRACTORS S PERVISOR (PRINT) �4E r;;�l ll-�-4 J&&, layy il-)7- 01 STREET ADDRESS SIGNATURE --s i, C-/ - 0 4 o 7 X A DATE TOWN // STATE ZIP INSPECTED BY TOWN DATE LEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS STREET / Y r Ant SUBDIVISION: NORTH ARROW t 3 � ; e 11 t It1_ ._ ow titi ' i Ij - I 1 111 i I t i , ------------ f x.� f , 44 It I i 3 f C-e,,)Sr" 6 �G Xr6J7 -e CONTRACTOR (PRINT) NAME OF ONTRACTOR'S SUPERVISOR (PRINT) 7 r ao?n rn LYc-e- ttlx, R. oo<— � STREET ADDRESS SIGNATURE4 fd 1 u7� k0e 0 j ®6 G "*7 DATE TOWN STATE ZIP INSPECTED BY TOWN 4?� O S'1 � '�—S'.Z DATE TELEPHONE NUMBER WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER