HomeMy WebLinkAboutDrain Layers Permit 28 Goodhill Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7125 Contractor GERBER CONSTRUCTION CO
Location GOOD HILL ROAD Address 616 DART HILL ROAD
Type Work SAN MAIN VERNON CT 06066
Phone, No. (860 )875-6684
Date Insp Needed
Time Insp Needed
Inspected By
Work in Progress
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Pevrfttt*o. 7125 Town of South Windsor, CT
Perri t' Date 03/21/2000 Drain Layer Permit
Expiration Date 04/20/2000
Descrip: REPAIR SEWER MAIN
Applicant Location
Name GERBER CONSTRUCTION CO , Adsr , � 000D HILL ROAD
Addr . 616 DART HILL ROAD Ow.ner, JOWN OF SOUTH WINDSOR i
VERNON CT AS( 9r
Phone No. (860 )8756684
The Drain Layer dss 1 gne ly 1ai`s perrf 1 t.has ,,a ua A d l i cense issued by the
state and hereby agrEjee� t� � t e `�m8 and` con�4ltio s set forth in the
_ attached 'Cond i t i ons'i°_. -A 11 Mork sha. f;� "i n a6c6rdan6e with Town of South
Windsor standards, al }SHI "r�equ r-�#nett , ..and,"; Ne attached conditions.
Issued By ' "A 17 -t-1e
Date Inspected y ,zg �31 .{I nspeclet By _
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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: zoh /
Lot #
Street No./ Street Name
Premises owned by: G� W�� d 1'd 4,Z
Name of Firm: , t�� 2 �G! Phone:
Address of Firm:
TYPE OF WORK:
Lay House Drain ; Rir House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Waterer 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 issue to _rA L, Lehr/ c the holder of Drain an
Layer's License No/° L -r Only 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: �p
Print Name:
Licensed Drain Layer
Date: dG
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET
+ SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CO CTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS SIGNAT
Q 0 6 d b 6 / o� DATE
TOWN --- STATE ZIP INSPECTED Y TOW
�C- DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER