HomeMy WebLinkAboutDrain Layers Permit 77 Lavender Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No, Cont.p&Ctor JACQUES»G_ONSTRUCTION (JOHN)
Location''' 14 Andre& 67 KIDGE ROAD.
Type Work NEW SAN LAT �+
SO UTH WT DaOR CT... 06074
Phone^.No
Date Insp Needed
Time
InP Needed !
v
s i�
2
Inspected BY
I
i
Work in Progress
--
Date
i
;i
Permit No. 8091 Town of South Windsor, CT
Permit Date 09/14/2006 Drain Layer Permit
Expiration Date 10/14/2006
Descrip: CK21100 USER FEE
Applicant
0 3.on
i
Name JACQUES CONSTRUCTION {JOHN) d . (;
Addr. 67 RIDGE ROAD
Ow Er JMJ COI'STRUCTION
SOUTH WINDSOR C.-T.-6 4 '
Phone No.
The Drain Layer ass giied'uh-* t � d by the
state and hereby agrees`'to a l the terms °aild Coidit:.x.ant:;.for th in the
attached 'Conditions'- 11 wade's i h x aft—ant w�Ltk TbWn of South
Windsor standards, all; OSHA
'a'# i2at =a' h
C ed o-odditions.21
11
1
Issued By --- ------ Tztle �^
Date Inspected
JY®
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, Cr
FEE $60.00
Location of proposed work: Ve?�7 cl il-
�
Street L Lot#� .
No. Street Name
Name of Firm: -
Phone.--2d
Address
.of Firm; s� '
TYPE OF WORK:
Lay House Drain • Re
Lay Mainpair House Drai
n ;
' Lay-Lateral'for Commercial/Industrial Building of�
. acres
Connection will be made with
Existing Water Supply: Public Water
Well
Proposed Start Date4�L Estimated time for completion
ALL WORK TO BE IN ACCORDANCE Wllli-TOWN_OF SOUTH
ALL OSHA REQUIREMENTS AND CONDITIONS A ACHED TO THE PERMIT DARDS,
Permit-is to be issued to o- J cl
Layer's License No. a 08R 3 0 e holder of Drain
Will be issued.a O Y holders of P-1, P-7 or W-9 licenses 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 r
Town Street Excavation Permit No, received
and/or ConnDOT Permit No.
CBYD No.
Signed:
Print Name: ToI.�Scz�V �S ice
-- - - -
Date:
Standard Forms kPermltSWPUCg1ON FOP,DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH ANDSOR
SANITARY -- SEWER LATERAL FIELD - LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET 6�Je
SUBDIVISION: f 7�S
NORTH ARROW
_
_71
I
--T
94
G 4t/°
P a ,
/O
E 1 i
CONTRACTOR (PRINT) r NAME OF ONT CTOR'S SUP SOR (PRINK
f tz vt c�(
STREET ADD/R'E,SSS. TURE
��v D�C1,741 ai o DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE TOWN PINK CONTRACTOR
YELLOW - CONSULTING ENGINEER / DEVELOPER .