HomeMy WebLinkAboutDrain Layers Permit 14 Kingsley Drive TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 7043 Contractor GERBER CONSTRUCTION CO i
Location 0014 KINGSLEY Address 616 DART HILL ROAD I
Type Work NEW SAN LAT VERNON CT 06066
Phone No. (860)875-6684
Date I nsp Needed A. 7 ,. Qte
Time Insp Needed Timms Insp. //=�O
Inspected By
Work in Progress
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npui _ Date $1311g5
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army o. 1043 lown o 0 uth Windsor,
Pprmit .Date 08/27/1999 Drain Layer Permit
Exp-ir,A lon Date 09/26/1999
.Descrip: SEWER USER FEE PAID
Applicant Location
Name GERBER CONSTRUCTION CO gddr. 0014 KINGSLEY G l�
Addr. 616 DART HILL ROAD Owner,-CHASE ORCHARDS LLC
P-
VERNON CT 06666,
Phone No. (860)875-6684
The Drain Layer as�i n d this per*tlt�t has g v& id license issued by the
state and hereby agrQes t« nal 1 "thy rft�< and, Qn #ibons set forth in the
attached 'Conditions ' A 1 Woek sh�lzI bra in accardanc with Town of South
Windsor standards, a I..OMA' rquirernl: and `the attached conditions.
Issued By �� PA T1t1'e - Ecr �C�G,tiErF�L
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Date Inspected 1'_ l 114pected By _
�045
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT l_
FEE $25.00
Location of proposed work:-
Lot #
Street No. St re Name
Premises owned by: CA CAs c-- �'1 rj be
Name of Firm: x - Phone:
Address of Firm:
TYPE OF WORK:
Lay House Drain v
Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with 7r
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
Layer's License No. /e� 7_.',�yf Z� of Drain
be issued a permit. Permit will expire thirty
holders of Pi, P7 & W9 licenses will
p rty(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.
4
Signed: Print Name: O
Licensed Drain Layer
Date: ?-'
Standard forms\Permits\APPLICATION FOR DRAIN LAYERS PERMrr.doc
.. I TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 'a-I -
BUILDING ADDRESS L 0'
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRA 0R'S SUPERVISOR (PRINT)\k
C� Orn Cam:
STREET ADDRESS SIGNATURE
.j - � �7 y DATE
TOWN STATE ZIP SP CTED BY TOWN
G 6 B DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER