HomeMy WebLinkAboutDrain Layers Permit 41 Madison Way r.
TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 7119 Contractor JACQUES CONSTRUCTION (JOHN)
Location 0041 MADISON WAY Address 67 RIDGE ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
Phone,,. No. (860 )432-1823
Date Insp Needed wi(' rA fit` ?� k4 ate.` Date Ins0. 3�14-I�o
Time Insp Needed {®ta A , ;1ri Insp: Nv-rEf�
Inspected By = 1A► '
Work in Progress 8'��- = pTv gf Q:u1� ' '_ c•N DuG�N�'. ror � , iftfu APPfARS
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# Input Date
R,e rr ft No. 7119 Town of South Windsor, CT
:Pel-mit Date 03/13/2000 Drain Layer Permit
Expiration Date 04/12/2000
Descrip; USER FEE PAID
Applicant Location
Name JACQUES CONSTRUCTION (JOHN).: -Add'r. 0Q41 MADISON WAY
Addr. 67 RIDGE ROAD w0er' J1- J CONSTRUCTION COMPANY INC
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SOUTH WINDSOR CT C� f4
Phone No. (860)432-1823
The Drain Layer ass°inel 1� �1-s Fermat has ;a valid l censa issued by the
state and hereby agrees ,a at l the "i~ei^tii ;;and ,t 6c tY;ohs set forth in the
attached 'Conditions"' --A l 3= yWrf^k shag i4i i n acirdance with Town of South
Windsor standards, a l .T -0S14Ae attached conditions.
Issued BY
Date Inspected 3 �'�� Irispectod By
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: 1 S Lot # /5
Street No. Street Name
Premises owned by: cs ��� � L L 6,
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 _ 57
Existing Water Supply: Public Water Well
Proposed Start Date C7 Estimated time for completion
ALL WORK TO BE IN CCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued W-Zh the holder of Drain
Layer's License No. 21281&�s® . Only holders of P1 or P7 licenses will be
issued a 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 received Town
Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No.
Signed:
Print Name: � C_cZ� �S
L cen Dr ' Layer
Date: / .
Standard Fo s\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD
LOCATION
DATE OF CONSTRUCTION: '-3 /Z/ -
BUILDING ADDRESS 'sue
STREET :
SUBDIVISION:
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CONTRACTOR (PRINT)r NAME OF CONTRAC SUPER OR (PRINT)
STREET ADDRESS SIGNAT
6pr 1A tn/ C� C/>'dr � DATE
TOWN STATE ZIP
INSPECT BY TOWN
- S6 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR
YELLOW - CONSULTING ENGINEER / DEVELOPER