HomeMy WebLinkAboutDrain Layers Permit 112 Loomis Roadf I
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7378 Contractor JACQUES CONSTRUCTION (JOHN)
Location Address 67 RIDGE ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
Pborhe No. (860)432-1823
Date Insp Needed L✓ �� Cf�L� pats, Insp / Cf'
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Time Insp Needed Time 1nsp,.
Inspected By
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Permit_ No 7378 Town of South Windsor, CT
Permit- Dat® 1 /22/2002 Drain Layer Permit
Expiration Gate 02/21 /2002
Descrip: CK11245 $875 .00 CK11246 $102 . 52
Applicant Location
Name JACQUE8 CONSTRUCTION A-JOHN)., A "d, - 112 OOMIS RD
Addr . 67 RIDGE ROAD C+wner ,CLARK REALTY
SOUTH WINDSOR CT 06b74
Phone No . (860)432-1823
The Drain Layer asi.anedi/s permit ,his a valid i`i�cense issued by the
state and hereby agree the . eel` and candjtjons set forth in the
attached 'Condi-tions' All tipr.k �, b in -,accordance with Town of South
Windsor standards, all O8H:A r1 uiremovts, and` the attached conditions .
Issued By
Date Inspected ��� --- -- .Inspected By _ --
kv APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DLF1,v%R.rM"ENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSoll CT
FEE $25 00
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Location of proposed work: / / Z' dv /s Lot #
Street No. Street Name
Premises owned by: LZ
Name of Firm: Phone: C;L 7;; 0 c�2
Address of Firm:
TYPE OF WORK:
Lay House Drain 1✓ ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water Well
Proposed Start Date/j o��—Q stimated 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 C/ z /rt he holder of Drain
Layer's License No. Only hol ers of P1 or P7.licenses will be
issued a permit. PERMIT WILL EXPIRE THIR (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.
CBYD No.
_ Signed: Print Name: � vas
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License rain La r
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Date: _
--- -Standard PormsftrmitsWPPLICATION FOR DRAIN LAYERS FERMI T.doc - - -
-A- TOWN OF SOUTH WINDSOR
SANITARY . SEWER LATERAL
-FIELD LOCATION
DATE OF CONSTRUCTION: I �'�
BUILDING ADDRESS
STREET 11.2- L o o/►-� l 5 i v a�
SUBDIVISION: n 1' 1
NORTH ARROW
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CONTRACTOR (PRINT) NAME 9F CONTRACTOR'S SUPERVISOR (PRINT_)
STREET ADDRESS _212�
,r SIGNATU E
. ®� ��'L-�`� 1JI-7 G 2- DATE
- TOWN STATE _ZIP -
d INSPECTED BY TOWN -
(3�C5 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER