HomeMy WebLinkAboutDrain Layers Permit 111 Gilbert Lane i.
-_ TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permllr : Vr�. 7346 Contractor JACQUES CONSTRUCTION (JOHN )
Location 0111 GI`LBERT LANf`'Y Address 67 RIDGE ROAD
Type W6rk NEW SAN LAT SOUTH WINDSOR CT 06074
P One No. (860 )432-1823
Date I nsp Needed will CA� Date£ rasp. �Z-0
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Inspected By
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Permit No. 7346 Town of South Windsor, CT
Permit Date 11/01/2001
Expiration Date 12/01/2001
Descrip: USER FEE PAID CK#11151
Applicant Location
Name JACQUES CONSTRUCTION (JQKN )� Addr s01� 1 GILBERT LANE
Addr. 67 RIDGE ROAD ` , Owner CLARK REALTY INC
SOUTH WINDSOR CT Q6 } 4
Phone No. (860)432-1823 ` F .
The Drain Layer as$ h t , t � pgrr � has a d , li-.cense issued by the
state and hereby agrer ; t ,i t nd tr �t�t, r s set forth_ in the -
attached Bondi ti ons' 'A;i ) �i'k shad ; .n acrda�nce with Town of South
Windsor standards, al T`�SF �, eganh attached conditions.
Issued BY - � � � �;� - T1n,<„��J f�l�
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Date Inspected l �SP;a�tey
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46
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN 'HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
J 1
Location of proposed work: l� � h Lot #
_77
JS�trreet No. S..trreet Name
Premises owned by: �/ G S t i
Name of Firm: Phone:-a
Address of Firm: 6S7_&" �j l9 5-0 v c
TYPE OF WORK:
Lay House Drain :2; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with 5
Existing Water Supply: Public Water Well
Proposed Start Date l Estimated time for completion
ALL WORK TO BE IN AC ORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to �g l ,�' I✓'co, the holder of Drain .
Layer's License No. 20-J& `ICJ Oly 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: �' j2 4Ce.0 -s
Licen d Layer
Date: ( ®/
Standard rms�Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 40 V, t 14
ltfiT7
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BUILDING ADDRESS .
STREET
SUBDIVISION: EO-qtej
NORTH ARROW
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CONTRACTOR (PRINT) NA E CONTRACTOR' SUPERVISOR (PRINT)
STREET ADDRESS SdATURE
. ► � S 8 Y T �� p 144 DATE
TOWN STATE ZIP INSPECTED BY TOWN
C6 0 L -b 27- DATE
-1EPHOA NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 7 ` /,X' 06
BUILDING ADDRESS
STREET 1-61 P 7 7 Gil i er-.r ILIA e
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF ONTRACTOR'S SUPERVISOR (PRINT)
'7 S' Cc, -
STREET ADDRESS SIGNATUREK
S'o yT A 4)) e)r/i,ty of 0(0 7 t/ DATE
TOWN STATE ZIP INSPECTED BY TOWN
F-d O S;� S�� s'Z DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER