HomeMy WebLinkAboutDrain Layers Permit 203-204 Wentworth Pa TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7930 Go`ntractot J &:H CONST CO
Location 203/204 WENTWORTH PARK Ac3ctres '' 75'` O[klEROE W' Y
Type Work NEW SAN LAT 5,6TI1I•>f<kJIN $,6R CT<::;.06074
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Permit No. 7930 Town of South Windsor, CT
Permit Date 06/14/2005 Drain Layer Permit
Expiration Date 07/14/2005
Descrip: INSTALL SEWER LATEgAL;:
on
Applicant Dnc t�::
Name J & H SLATER CONST C6„ bYt s Y. 2 3/ Q4 WE'NTi+fORTR PARK
Addr. 75 COMMERCE WA yeti.'.. ENERATIbN -
S'
31
i
SOUTH WINDSOR CT b607
Phone No. (860)528-5252
The Drain Layer">.assignt?d thisrfitit has � �d Z �e�lse sS'ued by the
and hereby a '�ee:sa:tp';_ `17;: <h:e. s:.foth in the
state a Y g
attached 'Conditions! All W&r steale r 3x c+�; anee,wI'th T.Own of South
%O ,,. oS'I hecnditions.
Windsor standards, all
Issued By ---- � Title .. ------------------
Date Inspected Inspected By
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work:_ Lot #_ C '�
Street No. Street Name
Premises owned by: i (Z, -yI L l t j-
Name of Firm:_ -i
Phone: SZ�-Sz�Z
Address.of Firm:_,--12r GNVU y(—:f 14cfz (J A j
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 C,115 Estimated 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 Jvw 5LkrejL the hold
er of Drain
Layer's License No. a-7 `7�+ff . Only holders of P-1, P-7 or W-9 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 pttached thereto. Applicant has received
Town Street Excavation Permit No. _iJ14 and/or ConnDOT Permit No.
CBYD No.
Signed: Print Name: Jaz!:S WJ 7St, BIZ
Licensed Drain Layer
Date:_
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMTT.doc
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS vG
STREET
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NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS SIGNATURE
`_S o urA cr , A DATE
TOWN STATE ZIP INSPECTED BY TOWN T
C�-6 � � S""�S 2 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER