HomeMy WebLinkAboutDrain Layers Permit 168 Gilbert Lane s a
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Dermit No. 7000 Contractor JMJ CONSTRUCTION CO.
Location 168 GILBERT Address 658 ELLINGTON ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
P ►bne,r-No. (860)528-7889
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Perth" No. 7000 Town of South Windsor, CT
Per'M— t Date 06/07/1999 Drain Layer Permit
Expj-ration Date 07/07/1999
De . '1p: CK 09036 775 . 00 CK 09038 195 .00
Applicant Location
Name JMJ CONSTRUCTION CO. �Aatr 1fi GILBERT
Addr . 658 ELLINGTON ROAD t �w sr" LARK REALTY
SOUTH WINDSOR CT . Y �d !!
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Phone No. (860 )528-7889 `? IT
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The Drain Layer ass Oreh s p�eft has d , 1 cense issued by the
state and hereby agr� t4� t4ee �. and ►i tits set forth in the
attached 'Conditions' . Al ¢ k 4ha'_ f n ac do with Town of South
Windsor standards, a i ll` 16ilk ched conditions .
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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
Location of proposed work: A? � agtfz 114 Lot #
St re-e No. Street Name
Premises owned by: � �s`
Name of Firm: �-� Phone: a �
Address of Firm: ,
TYPE OF WORK:
Lay House Drain Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Proposed Start Date Estimated time for completion l
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 the holder of Drain
Layer's License No. dmy holders of P1, P7 &W9 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.
Signed: Print Name: j6�L�QCf�c� SS
Lice ed 90i'n Layer
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMrr.doc
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
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DATE OF CONSTRUCTION: �.
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BUILDING ADDRESS 3
STREET
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CONT OR (PRINT) NAME C TRACT SUPERVISOR (PRINT)
STREET ADDRESS SI
5 le DATE
TOWN STA ZIP INSkCTED7Bf TOW
DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER