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HomeMy WebLinkAboutDrain Layers Permit 176 Pheasant Way TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 7053 Contractor GERBER CONSTRUCTION CO !! Location 0176 PHEASANT WAY Address 616 DART HILL ROAD { Type Work NEW SAN LAT VERNON CT 06066 Phone No. (860)875-6684 '1 i Ins Needed Z 'Date�,.,Insp. ,777 Date p Time Insp Needed 4•/`t. ,T- me ;Insp Inspected By s� Work in Progress S�k-�1� �i� 4 �,���� C1 tjd4T'J6•t�a /"7�•�`/t%dLc-G� II 4e, I. Input Date yla5� f I i Per-g4 Date 09/20/1999 Drain Layer Permit expiration Date 10/20/1999 Deser `p: SEWER USER FEE PAID Applicant Location Name GERBER CONSTRUCTION CO Addr. 0176 PHEASANT WAY Addr. 616 DART HILL ROAD Owner CHASE ORCHARDS LLC VERNON CT 06 -66 Phone No. (860)875-6684 The Drain Layer asqnsri this permit has a valid license issued by the state Wand hereby agrees,, 'G� dal i the at rmi ,and; ciondi tions set forth i n the attached 'Conditions'.. ,A11viQrk° ehal � b in accordance with Town of South Windsor standards, al:l. ©31 ;r' qu i rine�rlte., and: isM+a attached conditions. Issued By Title �a���£�� Date Inspected 9IZ3/9 >Inspepted 8y; a ��053 APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, Cr FEE $25.00 Location of proposed work:11V /Pq s j ), p p �l 'a� Lot Street No. Str et Name Premises owned by: Name of Firm: 6s — Phone: r Address of Firm: Yl Lt�t�cw p TYPE OF WORK: La House Dr y y am , Repair House Drain ; Lay Main ; Lay Lateral for Commercial/Industrial Building of acres a Connection will be made with � Proposed Start Date - 9 Estimated time for completion ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS, ALL OSHA REQUIREMENTS AND CONDITIONS TTACHED TO THE PERMIT Permit is to be issued to the holder of Drain Layer's License No. 1199 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: ��4Print Name: Licensed Drain Layer Date: Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: 2 5 4; BUILDING ADDRESS : LO 3 0 STREET + SUBDIVISION: NORTH ARROW P s-o i _44_. �__,_� _7 _p_ _..._I_ __ �__.-_ _-_ ___._ ....- Tl CONTRACTOR (PRINT) NAME ONTRACTOR'S SUPERVISOR ) It t STREET ADDRESS SIG E 11 L S A e A D c to 9 � DATE TOWN STATE ZIP INSPECTED OWN DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER