HomeMy WebLinkAboutDrain Layers Permit 110 Niederwerfer Roa i
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 6908 Contractor GERBER CONSTRUCTION CO
Location 0110 NIEDERWERFER ROA Address 616 DART HILL ROAD
Type Work RPR SAN LAT VERNON CT 06066
Phone. No. (860)875-6684
Date Insp Needed Date Irisp,
Time Insp Needed Timonsp ✓
Inspected By
Work in Progress
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Input ' Date
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Permit, No. 6908 Town of South Windsor, CT
Paww-its`Date 10/30/1998 Drain Layer Permit
Expiration Date 11/29/1998
Descrip: HAS FORCE LINE MAKING GRAVITY i
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Applicant Location
1
Name GERBER CONSTRUCTION CO Addy~. O'1.10 NIEDERWERFER ROA
Addr. 616 DVT HILL ROAD �0,wrpprPRENNAN JOLENE R
t 4 j
VERNON CT Qfi4
Phone No. (860)875-6684
The Drain Layer ash if�ocF th pe' 1 `lees 1-id 1 yjense issued by the
state and hereby agree t6 =aT_�th ` endnit,i, set forth in the 9
attached 'Conditions' �A 1 __ varic sh�►.1 b `n afl, `e�ace with Town of Southi
Windsor standards, all `O�iHA` n+ quirt rt , and th,6 attached conditions .
Issued By �'ri%� fr, #:Tj
ed �� ��
Date Inspect Inspectd° Br.r
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET : , Zia lvC l k er e_r4r
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SUBDIVISION:
NORTH ARROW 8 F µ
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
APPLICATION FOR DRAIN LAYERS PERMIT OW
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE;$25.00
Location of proposed work �� /Is� ' ��'^��i-��. Lot #
Street No. Street Name
Premises owned by: 40 .re.1,
Name of Firm: "� . '±; Phone:
Address of Firm: Gl .® ; / YL
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with �U
Proposed Start Date//-,7 ?dEstimated 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 �K �p},, .� C� the holder
of Drain
layer's License No. /'� Only holders of P1, P7 & W9 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.
Signed: Print Name
Licensed Drain Layer
Date: