HomeMy WebLinkAboutDrain Layers Permit 172 Pheasant Way TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7060 Contractor GERBER CONSTRUCTION CO
Location 0172 PHEASANT WAY Address 616 DART HILL ROAD
Type Work NEW SAN LAT VERNON CT 06066
Phone _No. (860)875-6684
Date Insp Needed �' gateIrisp.
Time Insp Needed A.M4 Time "Insp` ,
Inspected By �C fL T�rii
Work in Progress o� ic�a �7' " I` 1/6
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Input Date
Permit _NQ, 7060 Town of South Windsor, CT
Permit bate 10/04/1999 Drain Layer Permit
Exp_i-ration Date 11/03/1999
bescrip . SEWER USER FEE PAID
Applicant Location ,
Name GERBER CONSTRUCTION CO,-,, , ,, Ad' r.. 0172 PHEASANT WAY
Addr. 616 DART HILL ROAD Wne"r -CHASE ORCHARDS LLC
VERNON CT;>a6b66
Phone No. (860)875-6684
The Drain Layer a sui gt s+d 1rY�i`s per*, t-has 'a
has " a vat i d l.a cense issued by the
state and hereby agr4e 14 Che er s and c r�ditisns set forth in the
attached 'Conditions' . A I k, sh i i n a0010r�danc,e with Town of South t
Ni
Windsor standards, a11` OSW,4; requ3.cinent , end1i attached conditions.
I ssuxed By �, ��(�NI>
Date Inspected �- 5�� {, "„ Inspected .By
4 7o.6-0
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 07v Lot #
treet No. Stre t Name
Premises owned by: J5�ae
Name of Firm: /r—r_rhr� �°o�trhC Phone:
Address of Firm:
TYPE OF WORK:
Lay House Drain • Repair Ho
use ouse Drain ,
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with !� //�°
Proposed Start Date /° s 9y Estimated time for completion A
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 _ 1. ,r4cr fah Z.- the holder of Drain
Layer's License No. h2Z Z /s 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: E;cSe�
Licensed Dram Layer 100
Date:
Standard Forms\Permlts\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH ANDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS 35
STREET
+ SUBDIVISION: s
A- -D = 711
NORTH ARROW
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CON CTOR (PRINT) NAM C RACTOR S SUP VISOR (PRINT)
STR`EET ADDRESS SIG
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V Upon /6 7 DATE
TOWN STATE ZIP INSPE TED BY WN
DATE
TELEPH NE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER