HomeMy WebLinkAboutDrain Layers Permit 144 Gilbert Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7249 Contractor JACQUES CONSTRUCTION (JOHN)
Location 0144 GILBERT LANE Address 67 RIDGE ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
1 dne''No. (860)432-1823
Date Insp Needed 3 Z ,
Date Insp . 2-1s 6
Time Insp Needed Time Insp �s-
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Inspected By
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P ==No. 7249 Town of South Windsor, CT
Perri Date 03/21/2001 Drain Layer Permit
Expiration Date 04/20/2001
Descrip: LOT 86 CK10612 775 .00 10613 49 . 97
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Applicant Location 1
Name JACQUES CONSTRUCTION f JOHN-)" ,Addy.- 4714 Gi LBERT LANE
Addr. 67 RIDGE ROAD CL'1kR . REALTY INC
SOUTH WINDSOR CT,'f06t 74 j
Phone No. (860)432-1823 -
The flrain Layer ass �n�d` h prrgt haslicense issued by the
state and hereby agr6es � the and d itions set forth in the
attached 'Conditions' v 1I crfi 'z T a _a odd no with Town of South
Windsor standards, a 1 W r�qur- mie4rts, id #e��atirached conditions.
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Issued BY _�, !�.�-� `- — ,
ctedBy
Date Inspected
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS L ® 06
STREET
SUBDIVISION: P��
NORTH ARROW C-r E g
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
2 , ®a
STREET ADDRESS SIGNATURE
►�V ✓I o r c, O 6 Z� G DATE;
TOWN n STATE ZIP INSPECTED BY TOWN
o [J ozo, DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC.WORKS DEPARTMENT3P�c»aw
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Location of proposed work: �yy G'�/`��-� Lot #
Street No. Street Name
Premises owned by:- Ci0
Name of firm: Phone: e7kOa a�
Address of Firm: r !it J
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with SLI> 3 5—
Existing Water Supply: Public Water Well
Proposed Start Date 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 w 4CvZc>�S �J /Y�'cathe holder of Drain
Layer's License No. odd�'g'�D Only olders 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:
_20hkA dAcGzu�s'
License ra' yer
Date: 3 11 / �l
Standard Forms\Per Zts�APPLICATION FOR DRAIN LAYERS PERMIT.doc