HomeMy WebLinkAboutDrain Layers Permit 152 Gilbert Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT II
Permit No. 7086
Contractor JMJ CONSTRUCTION CO.
Location 0152 GILBERT LANE Address 658 ELLINGTON ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074 j
Phone No. (860)528-7889
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Date Insp Needed 11
Time Insp Needed TIme In p: A OoTEp
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Inspected By
Work in Progress 12/10
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Permit No. 7086 Town of South Windsor, CT
Permit Date 11/15/1999 Drain Layer Permit
Expiration Date 12/15/1999
Descrip: CK 9548 PRO RATE FEE
Applicant Location
Name JM,J CONSTRUCTION CO. Addr.,>, 0152 GILBERT LANE
Addr. 658 ELLINGTON ROAD Ovnerw :CLAI �C REALTY INC
SOUTH WINDSOR CT ;06Q74
Phone No. (860)528-7889 .'
The Drain Layer as8'a.8rfed-, the s parr,t -has a Va;j i d license issued by the
state and hereby agrees tro ;a1i thetets and condi ti ons set forth in the
attached Conditions'.. All .`=kirk shal,T, be , n accordance with Town of South
Windsor standards, a1- ' OSK1A,` re ui: +fir eats,,, and the attached conditions.
Issued By T=itie C c�►wF�(�,
Date Inspected azInspected By ls'l e
TOWN OF SOUTH ANDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS /_as
STREET : Of 2 e=,
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSO'R
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Location of proposed work: 61 (b��)�,., Lot # Ss-
Street
No. Street Name
Premises owned by:
Name of Firm: Phone:��"Oba9
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-PR .35—
Proposed Start Date Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATT CHED TO THE PERMIT
Permit is to be issued to u� (he holder of Drain
Layer's License No. B'3r7 Onl)(holders of P1, P7 &W9 licenses will
be.issued a permit. Permit will expire thirty ( ) 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.
Signed: Print Name:
Lice D rn Layer
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIEL.R LOCATION,.
DATE OF CONSTRUCTION: "' l /
BUILDING ADDRESS : Lot
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STREET
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SUBDIVISION: '
NORTH ARROW
CONTRACTOR (PRINT) NAME10F CONTRACTORS SUPER OR (PRINT)
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STfEEf'ADDRESS J NATURE
DATE
TOWN STATE ___ ZIP -- BY TOWN�
DATE
TELEPHONE NUMBER
WHITE - TOWN. PINK - CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER