HomeMy WebLinkAboutDrain Layers Permit 1 Riverview Drive F TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7672 Contr:ac£or J &`H""`S•Lg.TER CONST CO
Location 1 RIVERVIEW DR PODUNK RIDGE Aid re MMER.6 -,!T4Y
Type Work NEW SAN LATQUTH WINDOOR CT. 06074
Phone N<) ($60•)528 '52,52
Date Insp Needed _ Date Ixsp
Time Insp Needed Time
Inspected By
Work in Progress
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Input - Date
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Permit No. 7672 Town of South Windsor, CT
Permit Date 09/22/2003 Drain Layer Permit
Expiration Date 10/22/2003
Descrip: FEES FOR 28,36,40,70,7:$,P4 95,69 SAME CHECK
Applicant LDCAtion
Name J & H SLATER CONBT CO Adf 1.,RIVRV.I.EW BI2:.PQDUNK RIDGE
Addr. 75 COMMERCE WAY
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SOUTH WINDSOR CT. 06074
Phone No. (860)528-5252
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The Drain Layer [assigxled thiserri( a.srkd lcenpe 'issued by the
state and hereby agtees' toi-:the terms and condatianls set :;.forth in the
attached 'Conditions' All wCrY]c sha1T . 1 &ccandance with Tgwn of South
Windsor standards, all 0SNA r0quirem ratsx grid the attached caiiditions.
/� � tl Titles Issued By
Date Inspected _—_—_—__ Inspected By
0Q9 � r
CA �19 APPLICATION FOR DRAI N LAYER PERMIT J�,`� 40
TOWN OF SOUTH WINDSOR 5�
PUBLIC WORKS DEPARTMENT $ ��� - 0�� TOWN HALL
v 9 9 1540 SULLIVAN AVENUE .08
SOUTH WINDSOR, CT
FEE $60.00 5 \ G
6 4
'Pow 14 ic, �_i o C,,E7 5
Location of proposed work: tLi-A tk TO i . A Lot #_
U`7-" Street No. Street Name ( , ( C �
Premises owned by: Kfc i f r c\ Qw kLld-( PA.
Name of Firm: 06t;4r �.
Phone:. �
Address of Firm: -T �yliZI �
_TYPE OF WORK:
Lay House Drain__► Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water Well
Proposed Start Date 9- 13-0 Estimated time for complefiion rt(b��T1-I
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 if-jZ the holder of Drain
Layer's License No. 26" 17 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 a d6attached thereto. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No.
Signed: Print 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:
BUILDING ADDRESS IT/ 6t'b
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
TOWN !! STATE ZIP INSPECTED BY TOWN
b 0 J g V �� A_ DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER