HomeMy WebLinkAboutDrain Layers Permit 434 Pleasant Valley Y
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 8105 Con.ttxa`Ctor J & H''S'LA:TER CONST CO
Location 434 PLEASANT VALLEY',ROAD cTdze 75 CQMM,ERCE"Ld.
Type Work NEW SAN LAT ;::.:SG:UTH WT 69OR dT. 06074
Phone:';ido. ;18 'p;'1>b2HDS'.52 ".:.
Date Insp Needed Dates Tnsp
--------------�--� r-- :.
Time Insp Needed ----------- Iis Ip
Inspected By / .
Work in Progress ��,.}i!a e�✓ " 5 s -: f C� +Y
r..
i
— ------------------------
--------------
i
Permit No. 8105 Town of South Windsor, CT
Permit Date 10/19/2006 Drain Layer Permit
Expiration Date 11/18/2006
D escriP INSTALL SANITARY L AT;EI2AL::
Applicant
oat ::on
Name J & H SLATER CONS3 O 4 k. Pi,EAA#T GALLEY ROAD
Addr. 75 COMMERCE WAY finer-DEPIETTQ- Et3E ''& KATHLYN M
g �
SOUTH WINDSOR CT.: 06074
Phone No. (860)528-52.52
The Drain Layer assi.gnsi- this psr�nat has aa3id 1oense •isaued by the
state and hereby agree: '"'ta;'a '1`€the "Eerms°'arid co4Hi.>".:abn; >>s,et>.,:�or:Eh in the
r
attached 'Conditions' All WoshI' bxtordanc; W,sth Town of South
Windsor standards, att'ad':;;;.conditions.
Issued By � ^+ T3tic:i..,...
------------------- ,--- ---? -- -------------------
Date Inspected Irisp'ecCe... By
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
43
Location of proposed work:
S Lot
tr #.
eet No. Street Name
Premises owned b
Name of Firm:
Phone: 2�Z
Address.of Firm:
TYPE OF WORK:
Lay House Drain Repair House Drain
Lay Main . . . •
Lay:Lateran for Commercial/Industrial
Building of. acres
Connection will be made with P(Ir
Existing Water Supply: Public Water x 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 cJ �
Layer's License No. '7-u?-T� the holder of Drain
will be issued.a Only_holders of P-1, P-7.or W-9 licenses
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.
Town Street Excavation Permit No. Applicant has received
and/or ConnDOT Permit No.
CBYD No.
Signed: Print Name. TE-
'censed Drain Layer
Date: IN tq 6 6
Standard F0ms\Perm1tsWPLICA110N FOR DRAIN LAYERS PERMIT.doc
t TOWN OF: -SOUTH . WINDSOR
SANITARY SEWER *LATERAL TIELD �- LOCATION
DATE OF CONSTRUCTION.
BUILDING ADDRESS Z
STREET
SUBDIVISION: 0 erg >y e l i-a C J- f4 7r j,
NORTH ARROW
Ao
S
91 6 _
_ _ s _
a '
I� ,C 4f e r 0 A S-1- ed
CONTRACTOR (PRINT) NAME OF CO RACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS '- SIGNATURE
_ It/ chy Y cr U d 0 7 Y ��, �-�� d��I 9 f% DATE
TOWN STATE ZIP INSPECTED BY TOWN
D, DATE
TELEPHONE NUMBER
WHITE TOWN PINK CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER