HomeMy WebLinkAboutDrain Layers Permit 44 Lavender Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 8050 Cont wj..tor ,JACQOEk" O,TSTRUCTION (JOHN)
Location 44 LAVENDER LANE Address .67 RAG ROAb>
Type Work NEW SAN LAT Sf?(JT WIND'SOR> CT<;-;06074
Phon 96Q)432 1823
Date Insp Needed ------------- ----� D`at�+ TMs f
Time Insp Needed ------------- Time;IrfX _ J :: IFS".1
Inspected By
Work in Progress 44-1
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Permit No. 8050 Town of South Windsor, CT
Permit Date 05/04/2006 Drain Layer Permit
Expiration Date 06/03/2006
Descrip: INSTALL SANIT. SEW. I�fiE ". '
Applicant
es
Loa.t .on
M.
Name JACQUES CONSTRUCTIOLd { 6fiN 44;LlkVENDER LANE
Addr. 67 RIDGE ROAD
Ob er JMJ CONS,TRUCT10N
SOUTH WINDSOR CT D607.4
Phone No. (860)432-1823- :'
The Drain Layer assigned s Ad lxcnse assued by the
state and hereby agrees 'tq.lile. 3: C'eYms rYd Cf7tic4st,.;on_ ,;.
a setiforth in the
attached 'Conditions A'l1 wo l'.I: 4nGe wit Town of South
Windsor standards, all OSHA re` .uren61Cs art q. h� attaohed.;._cbn't3itions.
Issued By ----- frA � 3
---------
ol
Date Inspected
--------------------- pe.ete.d:<::: •y --- -----— —
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT-
FEE $60.00
Location of proposed work: � Low �✓' 1.
Lofi#
Street No. h �_
Street Name
Premises T /
Name of Firm:
. Phone: vl��
Address.of rrm: '
TYPE OF WORK: /
Lay House Drain ✓ • Repair House Drain
Lay Main
Lay•_Lateral-for Commerdal/Industrial
Building of.
acres
Connection.will be.made with3S-
Exisfing Wafter Supply: LPD11C'
at
Well___-_____
Proposed Start Date mated tfine for completion
1.
ALL WORK TO BE IN ACCORDANCE WITH-TOWN OF SOUTH WINDSOR ST
All OSHA.REQUIREMENTS AND CONDITIONS A ACHED TO THE PERMITDARDS,
Permit is to be issued to --� - � ✓
Layer's License No. ao��'3� the holder of Drain
will be issued.a O y:hoiders of P- , P-7 or W.9 lioertses
Permit PERMIT WILL EXPIRE THIRTY(30)`DAYS AFTER
DATE OF ISSUANCE. The undersigned Drain Layer hereby agrees to all the terms
-and conditions.set forCh in the permit and attached thereto.
Town Street Excavation Permit No. Applicant has received
and/or ConnDOT Permit No.
CgYD No.
Signed:
4nc �
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LPrint Naive: Zk2v) �4C. r�QS
r e
Date: �/
StandaM Forms\ aM*SWPLiCATION FOR DRAIN LAYERS PERMIT.doc . . .
} TOWN OF SOUTH WINDSOR
SANITARY : SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: a
BUILDING ADDRESS n ► L�
STREET q q L 4-
SUBDIVISION: et- r /-
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'=PERVISOR ( INT)
STREET ADDRESS SIGNATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER