HomeMy WebLinkAboutDrain Layers Permit 96 Loomis Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
-Permit No. 7587 Contractor JACQUES CONSTRUCTION (JOHN)
Location Address 67 RIDGE ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
ne No. (860)432-1823
Date Insp Needed 4ns 10 o'er
r
Time Insp Needed
i
Inspected By
ci
Work in Progress C.c `rib
WV r.
i
C�-wsl
DateOR C-10
_ l
!i
I�
Piri'to. 7587 Town of South Windsor, CT
Permit Date 10/08/2002 Drain Layer Permit
Expiration Date 11/07/2002
Descrip:. CK 12029 •$157 .50 CK 12028 $910.00
Applicant Location
Name JACQUES CONSTRUCTION A LOOMIS RD
Addr. 67 RIDGE ROAD Ner<CL_ K REALTY
-SOUTH WINDSOR C
Phone NO. (860)432=182
The Drain Layer s i ha icons issued by the
state and hereby ag 1 an t° i ns set forth in the
attached 'Condition in 44b e with Town of South
Windsor standards, a 1 e ached conditions.
Issued By
OPP—
Date Inspected ria y
1
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: 0('19 Loom l S Lot #_
Street'No. Street Name
Premises owned by: yT - -1�
Name of Firm: Phone:
Address of Firm:
TYPE OF WORK:
Lay House Drain ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with S 3
Existing Water Supply: Public Water Well
Proposed Start Date o Q' 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 m -�eS , `Tc�phe holder of Drain
Layer's License No. _ � Only holders of P1 or P7 Licenses will be
issued a permit. PERMIT WILL EXPIRE THIRTY (30) DAYS AFTER DATE OF
ISSUANCE. The undersigned--Drairr-Layer hereby-agrees to-atl 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.
CBYD No.
Signed: Print Name:
License rai yer
Date:
-Standard For s\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.dac -
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL
FIELD LOCATION
DATE OF CONSTRUCTION
BUILDING ADDRESS , G
STREET L.00 m;s
SUBDIVISION: + ` 1' Es
NORTH ARROW
I .
i
.-- - i.._.. •' . f : i
l
i .
s
i � {
ti ;
{
_.._1
t f t
a
k I
i- i t
1 A
tt
` l
CONTRACTOR (PRINT) I-N E OF C NTRACTO ' SU V (PRINT)
STREET ADDRESS SIGNATURE
G J i v►` ry► P.,� r - DATE
rs��
-----TOWN----- _— STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER