HomeMy WebLinkAboutDrain Layers Permit 180 Pheasant Way ill
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7049 Contractor GERBER CONSTRUCTION CO
Location 0180 PHEASANT WAY Address 616 DART HILL ROAD
Type Work NEW SAN LAT VERNON CT 06066
Phone: No. (860)875-6684
Date Insp Needed 9/�f/�� Date-, Insp. 2/ 9
Time Insp Needed Al - , Time I`InspN /� • i`'/ ,
Inspected By
Work in Progress
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Per a` No, 7049 Town of South Windsor, CT
Merit Rate 09/14/1999 Drain Layer Permit
Expir4tion Date 10/14/1999
Descrip
Applicant Location
Name GERBER CONSTRUCTION CO . Addr 01.80 PHEASANT WAY
Addr. 616 DART HILL ROAD pw ►er CHASE ORCHARDS LLC
VERNON CT
Phone No. (860 )875-6684 t
The Drain Layer assigned; th4s per*i has vat c l a cense issued by the
state and hereby agrere�$ to _ Yl the tern& " rii�nl�ti6ns set forth in the
attached 'Conditions' .. Al ) "^k shA1 1 b' i n ap66r'd*npO with Town of South
Windsor Stan ards, all OSH1w;'� gr� entw� and ,he attached conditions.
Issued By
Date Insp cted Z/ _ Inspected BY
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00 �t�s�� l��
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Location of proposed work: Lot # 3
Street No. Street Nam
Premises owned by: aS le— rC'o 4►' , es
Name of Firm: nb--h- Cod 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 )!s e_,
Proposed Start Date 9-JY Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITION ATTACHED TO THE PERMIT
Permit is to be issued to C6j-. �t, • the holde
r of Drain
Layer's License No. f7 Ziff 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:
Standard Forms\Permlts\APPLICATION FOR DRAIN LAYERS PERMrr.doc
1 TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS `1
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CON TOR SUPERVISOR (PRINT)
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STREET ADDRESS SIGNATU
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TOWN STATEc� ZIP INSP CTED BYIfOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER