HomeMy WebLinkAboutDrain Layers Permit Fieldstone Sewer Mai `� TOWN OF SOUTH WINDSOR INSPECTION REPORT
Perr, it No. --y-6A-3 Contractor J & H SLATER CONST CO
Location .FIELDSTONE SEWER MAIN Address 75 COMMERCE WAY
.Type Work SAN MAIN - ;s SOUTH WINDSOR CT 06074
R' a e INo. (860 )528-5252
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Date I nsp Needed
Time Insp Needed A
Inspected By-Work in Progress
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Permit No. 6613 Town of South Windsor, CT
Permit Date 05/16/1997 Drain Layer Permit
Expiration Date 06/15/1997
� Descrip: SEWER MAIN FIELDSTONE SUBDIVISION
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Applicant _ - Location
Name J & H SLATER CONST CO Adr,. fTiLDSTONE SEWER MAIN
Addr. 75 COMMERCE WAY `
SOUTH WINDSOR CT6(3�4r '
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Phone No. (860)528-5252 � �, VA
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The Drain Layer asr� c1s , s ; = Yvlicense issued by the
state and hereby agre $ T t nd n set forth in the
attached 'Conditions' W { Ri ac 'r a with Town of South
Windsor standards, al
� ched conditions.
c Issued By �.JC�/ids �,,�� � ? P
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Date Inspected _ �a�
APPLICATION FOR DRAIN LAYERS PERMIT
' TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work: Lot #
Street No. Street Name
Premises owned by: {�
Name of Firm: Zip h( Anst Phone: nZS
Address of Firm: 75
TYPE OF WORK:
Lay House Drain Repair House Drain ;
Lay Main x ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with g 4 A��
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 the holder of Drain
layer's License No. Only holders of P1, P7 & W9 licenses will be
issued a permit. Permit wii 1 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 T wn Street.
Excavation Permit No. and/or ConnDOT Permit No.
Signed: _ L
Print Name6`i2
Licensed Drain Layer
Date: '