HomeMy WebLinkAboutDrain Layers Permit 71 Lavender Lane pp-
t TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No 6096 Conti. or JACQUES ' ONSTRUCTION (JOHN)
Location E A'ddres�. 67 1ZTDG,� ROAD.
Type Work NEW SAN LAT .;;.::SOU.T _WIND CP:.:.06074
Phone""t.o 489:0432 .1523
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Date Insp Needed Date 2n'
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Permit No. 8096 Town of South Windsor, CT
Permit Date 09/27/2006 Drain Layer Permit
Expiration Date 10/27/2006
Descrip:
Applicant Loe:ation
Name JACQUES CONSTRUCTI:6N: lOFiN) -dd 71 >LaT7EiFDER LADE
Addr. 67 RIDGE ROADw11fi;r
SOUTH WINDSOR CT.;;A6074
Phone No. (860)432-1823
The Drain Layer ass gi tT- his permr�t Aas a �ralid Iicense issued by the
state and hereby agrees:: to eI7 tteextnt crisiditiozs get forth in the
attached 'Conditions' Ali �3k sh&T] bb > rt acnrdaea with Town of South
Windsor standards, aI1:-OSHA zqu� etrfen$$, rind Cta ahtached conditions.
Issued By
------------------
Date Inspected ----------------- .. I' sp,e"ted,,:By.:::. -'
y
APPLICATION FOR DRAIN LAYER PERMIT Oct to
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work G
-- -- Lot#�Y .
Stree No. Street Name
Premises own b Y:
Name of Firm: - -.
Phone:
Address.of Firm: $'
TYPE OF WORK:
Lay House Drain Repair House Drain
Lay
Main.— L.aY Lateral-for Commerci
Buildin al/Industrial
Building______.*Of acres
. �
Connection will be made withS—
Existing Water Supply: Public Water Well
----___—
Proposed Start Date,*23
'mated 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 b r/I cT e» fy�
Layer's License No. � �,�� `e holder of Drain
will be issued a On holders of P-1, P-7 or W-9 licenses
Permit. PERMIT WILL EXP RE THIRTY(30)'DAYS AFTER
DATE OF ISSUANCE. The undersigned Drain Layer hereby agrees to all the terms
.. and conditions set forth in the
Town Street Excavation PermitNQ rt and attached thereto. Applicant has received
and/or ConnDOT Permit No.
CBYD No.
Signed-
Print Name: ��C1StC._k_ Lice •p��� _--
Date:
Standard FOMSTerMIMAPPLICATION FOR DRAIN LAYERS PERMI Edoc
TOWN OF SOUTH WINDSOR '
SANITARY SEWER LATERAL FIELD ' LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET : ,. bl
SUBDIVISION: ✓'
NORTH ARROW
_ T.
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S R
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oG► � L> -
CONTRACTOR (PRINT) I E OF CONT R'S �bPERVISOR (PRINT)
�
STREET ADDRESS
SIGNATURE
zu l(71/ ®!� DATE
TOWN STATE ZIP INSPECTED BY TOWN
- DATE
TELEPHONE NUMBER ;
WHITE - TOWN PINK'- CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER