HomeMy WebLinkAboutDrain Layers Permit 15 Riverview Drive ij
TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 7684 Cont:ract'or -SLAATER CONST CO
Location 15 RIVERVIEW DR Address:l i 75 COMM.ERCE'WAY
Type Work NEW SAN LAT aOUTH WIND,
$OR C:T 06074
Phone =Na (80)528 'S�52
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Permit No. 7684 Town of South Windsor, CT
Permit Date 10/22/2003 Drain Layer Permit
Expiration Date 11/21/2003 j
Descrip: CK 10900 $6639.00 SIX PE�MIIS 0 CASH
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Applicant Locaion s
Name J & H SLATER CONST .GQ dd 75,. IVERVIEW D12 '
Addr. 75 COMMERCE WAY Other RSK KE
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SOUTH WINDSOR CT 0$074 `
Phone No. (860)528-5252
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The Drain Layer aasigneid tli1-s per!nzt h'i a 1.-Alad l oense; issued by the
state and hereby agrees .tq 1 the t'eYms and esrditxog set;:forth in the i
�i'11 work sha3 attached 'Conditions' 'l b asp aordanee with Town of South
Windsor standards, all OSHA xequirementsR and.the attached conditions.
Issued By T z t 1 e.:; _ -----------------
Date Inspected `Inspected ty _ '
- TOWN OF SOUTH WINDSOR
SANITARY* 'SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS ; . �� a'io �I
STREET /,i y62,/1 6-� p LI 6
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
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STREET ADDRESS SIGNATURE
Lx'r� l ny DSO a'7 .�.� .� try �� D
ATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: Fbo,(J a
Street No. Street Name
Premises owned by: R-5 �cl
Name of Firm: �-C � _ CL adsc lei L hlC- Phone:
Address.of Firm: avuH�,ra�c2
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TYPE OF WORK:
Lay House Drain ; Repair House Drain
Lay Main ; Lay Lateran for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water x Well
Proposed Start Date 1(-2-3-0_ 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 _cI T�i� the holder of Drain
Layer's License No. �'7 74 Only holders of P-1, P-7 or W-9 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:_ 5tA—,�-(L
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMTT.doc