HomeMy WebLinkAboutDrain Layers Permit 12 Riverview Drive TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7674 Co;itractor J & H SLATER CONST CO
Location 12 RIVERVIEW DRIVE Address ,'>- 75 M.KIERCE"WAY
Type Work NEW SAN LAT SOUTH W1 ND,
SO:R CT. 06074
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Date Insp Needed ------------------
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Time Insp Needed -------—----— — Time Trieg _ � R '
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Permit No. 7674 Town of South Windsor, CT
Permit Date 09/26/2003 Drain Layer Permit
Expiration Date 10/26/2003
Descrip: CHECK FOR 2 LOTS #12 &,.;#31
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Applicant L4CaC'ion
Name J & H SLATER CONST C0 AC.t�r ;1 RIVEEtVIEW'.nRIVE
Addr. 75 COMMERCE WAY
SOUTH WINDSOR CT 06074
Phone No. (860)528-5: 52
The Drain Layer assagned tFis PexaS itdli.d license issued by the
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state and hereby agrees to a the terms and cond�,t 009 set..:>fotth in the
attached 'Condition"s' . All woirk slial bi.. tcordanc...e with Town of South
Windsor standards, all OSHA re't�uirem-ent ,. axis the attached:conditions.
Issued By
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Date Inspected
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• TOWN OF SOUTH WINDSOR
SANITARY` SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: - 3
BUILDING ADDRESS T_*1
STREET 91V ► �
SUBDIVISION: t LAt 9 l b 6 e
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS p SIGNATURE
5b L4 1' 0) a h 5 eet. �� l�k�b� `� � ��3��y y DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER'
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
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:juu, �4 Zi l � Lot #
Street No. Street Name
Premises owned by:
Name of Firm: ' k Phone: ,SL8 sZ�Z.
Address.of Firm:-7S a Mae ok Glom
TYPE OF WORK:
Lay House Drain_; Repair House Drain
Lay Main ; Lay Lateran for CommerciaVIndustrial
Building of acres
Connection will be made with P!�(
Existing Water Supply: Public Water_ Well
Proposed Start Date -ZJ Estimated time for completion 2 aS
ALL WORK TO BE IN ACCORDANCE WM TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to S cj• S(Azrt, the holder of Drain
Layer's License No. ?617 t 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 arid attached thereto. Applicant has received
Town Street Excavation Permit No. A/ and/or ConnDOT Permit No.
CBYD
Sign rint Name: jAt v w 5v}1r--
Licens d rain Layer
Da e:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc