HomeMy WebLinkAboutDrain Layers Permit 55 Loomis Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7444 Contractor JACQUES CONSTRUCTION (JOHN )
Location 4"' Address 67 RIDGE ROAD
Type Work NEW SAN `LA SOUTH WINDSOR CT 06074
No. (860)432-1823
Date Insp Needed AS /I 0
Time Insp Needed
Inspected By
Work in Progress Ec• a uc)
5 u rl'G�h Cat�• i h. 'c� -
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no Date
PePri
it90 7444 Town of South Windsor, CT
Pee-mi t -Dat•e -0'6/10/2002 Drain Layer Permit
Exp4tation' Date 07/10/2002
Descrip: CK 11648 $17 . 12 11634 $875 .00 !
Applicant Location
' Name JACQUES CONSTRUCTION O1 5 OOMIS RD
Addr. 67 RIDGE ROAD L REALTY
SOUTH WINDSOR, CT
Phone No. (860)432-1823 ,
'The Drainlayer as cense issued by the
s8 s _
state and hereby agr e8- h _,. nd i s set forth in the
attached 'Conditions' 1 r a c with Town of South
Windsor standards, al q ached conditions.
A
Issued By
y
, , Date Inspected ee e
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
9
Location of proposed work: Lot # _
Street No. Street Name
Premises owned by:
Name of Firm: Phone: g O&t3'g
Address of Firm: g'
TYPE OF WORK:
Lay House Drain ; 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.,' Estimated time for completion PA 3e'
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 ® as the holder of Drain
Layer's License No. 36 0 y holders of P1 or P7 licenses will be
issued a permit. PERMIT WILL EXPIRE TWRTY (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:
Licensed in
Date:
- Standard Forms\Permits�APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: T14 0 e 1 �-
BUILDING ADDRESS
STREET : 1s L�
SUBDIVISION: 2e,2, j," 4 EclAtpj
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SLIPERVISOR (PRINT)
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STREET ADDRESS - SIGNATURE
LJ,, S OY �P1 7 z
DATE
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T WN // STATE ZIP INSPECTED BY TOWN
0 "O DATE
VLEPHOVE NUMBER .
WHITE - TOWN `- PINK - CONTRACTOR
YELLOW - CONSULTING ENGINEER / DEVELOPER