HomeMy WebLinkAboutDrain Layers Permit 160 Gilbert Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7120 Contractor JACQUES CONSTRUCTION (JOHN)
Location 04-52 GILBERT LANE Address 67 RIDGE ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
Phone No. (860)432-1823
Date Insp Needed Date 'Insp'
Time Insp Needed Tine `Insp` . " . AS NOTED
Inspected By � �►
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+Permi-t No. 7120 Town of South Windsor, CT
Per_vjr Date 03/13/2000 Drain Layer Permit
-Expiration Date 04/12/2000
Descrip: USEgV6EE PAID
+Applicant Location
Name JACQUE MISTRUCTION (JOH_N4 ,kddr.__, 0152 GILBERT LANE
Addr. 67 RIDGE ROAD Cvher. CLARK REALTY INC
SOUTH WINDSOR CT 060 �4 "
Phone No. (860)432-1823
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The Drain Layer asb*s , id ;1%i tense issued by the
state and hereby agr t�� t Tth t An boqn6ltion s set forth in the
attached 'Condit tons" �=A c k i i n c r.0anP,0 with Town of South
Windsor standards, a 1� ,D qu i � r , n , and't at, hed conditions.
All
Issued BY —
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Date Inspected 3 6tV # exited A eXWA ��
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
160
Location of proposed work: /§� 6j I b/I f//I Lot # g-�e+
Street No. Street Name
Premises owned by: i�� C6r4_St-,
Name of Firm: Phone: 2,,F
Address of Firm:
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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—
Existing Water Supply: Public Water Well
Proposed Start Date.3 ®O 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 h the holder of Drain
Layer's License No. - F22 Only holders of P1 or P7 licenses will be
issued a permit. PERMIT WILL EXPL 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: Print Name: &kl2yl
C -Lice ed Dr n Layer
Date: / a
Standard Form Perms \APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: lnqyrc-h Ut, a o o o
BUILDING ADDRESS L® �
STREET
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SUBDIVISION: JAf-�U
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPE VISOR (PRINT)
13-9- ah�l� L.40L: 3
STREET ADDRESS "" S NATURE
J- CT- 06 0 7 q DATE
-_ - TOWN`` STATE ZIP - INSPECT TOWN
DATE
TELEPHONE NUMBER -
WHITE - TOWN PINK _
,:- CONTRACTOR `t5 YELLOW - CONSULTING ENGINEER / DEVELOPER