HomeMy WebLinkAboutDrain Layers Permit 63 Loomis Road Permit No.' 7420 Town of South Windsor, CT
Permit Date 05/09/2002 Drain Layer Permit
Expiration Date 06/08/2002
Descrip:
Applicant Location
Name JMJ CONSTRUCTION CO.
Addr. 658 ELLINGTON ROAD
SOUTH WINDSOR CT
Phone No. (860)528-7889
The Drain Layer a s s as 1 'cense issued by the
state and hereby agr nd io s set forth in the
attached 'Conditions' . 1 a with Town of South
Windsor standards, al q ached conditions.
Issued By
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TOWN OF SOUTH WINDSOR INSPECTION REPORT 1'
Permit No. 7420 Contractor JMJ CONSTRUCTION CO.
Location Address 658 ELLINGTON ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
No. (860)528-7889
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Date Insp Needed ! s ItS 02-
Time I nsp Needed
Inspected By
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Location of proposed work: Lot # �
Street No. Street Name
Premises owned hv- CzQy ✓,
Name of Firm: Phone: L
Address of Firm: 5-95 wit
TYPE OF WORK:
Lay House Drain , Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with A R- 3 T < `
Proposed Start Date Jc- a ):�:: Estimated time for completion �D
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 Je hJ'AcavzfS J the holder of Drain
Layer's License No. -�099 _70 .(my holders of P1, P7 & W9 licenses will
be issued a permit. Permit will expire thi. (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.
Signed: Print Name:
Licensegffrai yer
Date: J^
Standard-Forms\Permits\APPLICATION FOR DRAIN-IAYERS-PERMrr.doc — - — -
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
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CONTRACTOR (PRINT) NAME OF CONTRACTOR S RVI PRINT)
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STREET ADDRESS SIGNATURE
� ► n ,F�� C�- d6(gy !S(OL DATE
-TOWN-< pp - -,_ 0- STATE _ ZAP INSP ED BY TOWN
�OX Q�iB DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER