HomeMy WebLinkAboutDrain Layers Permit 140 Pheasant Way TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 7151 Contractor JMJ CONSTRUCTION CO. !'
Location 0140 PHEASANT WAY Address 658 ELLINGTON ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074 I)
FhotTe No. (860)528-7889
Date Insp Needed (A),(1 (4( Effete �Ins Z� o�, it
Time Insp Needed P/`h Tim ';Tnsp g':IS
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Input Date
Permit No. 7151 Town of South Windsor, CT
Permit Date 05/22/2000 Drain Layer Permit
Expiration Date 06/21/2000
Descrip: -PRO RATED FEE -- $16. 25 CASH
Applicant Location
Name JMJ CONSTRUCTION CO. Addr,J 010 PHEASANT WAY
Addr.� 658 ELLINGTON ROAD wner �JMJ =.CONSTRUCTION COMPANY
SOUTH WINDSOR CT '06g4
Phone No. (860)528-7889 -+
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The Drain Layer th.#s rmq t has a val'7 d 1.ry cense issued by the
state and hereby agre ' t t�her �; and - oitios set forth in the
attached 'Conditions' A 1 W0rk _zat-va1_J n aec r an a with Town of South
Windsor standards, a 1 1 OSF{A ' egi:Ft'�til .hia :s; end the attached conditions.
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Issued By TI't1
Date Inspected 5 ZG Oo
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:- of #�
Street No. Street Name
Premises owned by:
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
Existing Water Supply: Public Water Well
Proposed Start Date 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 ✓� the holder of Drain
Layer's License No. 1lSIS3d my 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:
Licensed Win L
Date:
Standard F rms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH ANDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S 210PERVISOR (PRINT)
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STREET ADDRESS 0 d 2 c f SIG TURF
I110 -s w , Cplor,�-a _�(��G� DATE
TOWN STATE ZIP INSPr BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER