HomeMy WebLinkAboutDrain Layers Permit 21 Riverview Drive * TOWN OF SOUTH WINDSOR INSPECTION REPORT j
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Permit No. 7671 Cont raCt`t"r"J &"''FI S.LATER CONST CO
Location 21 RIVERVIEW DR PODUNK RIDGE Address::: 7543MM..:ERC "::wAY
Type Work NEW SAN LATQUTH WINDSOR CT 06074
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Phone No f$�U)52$ "5252 ..
Date Insp Needed Date I &p3
Time Insp Needed _-------- — Time Itg, . J
Inspected By
Work in Progress
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Permit No. 7671 Town of South Windsor, CT Permit Date 09/22/2003
Drain Layer Permit !j
Expiration Date 10/22/2003
Descrip: FEES FOR 28,36,40 70 7$ 94 95 6g,g1.t21 1`°SAME CI# .CK
Applicant Location
Name J & H SLATER CONST CO �1dr3 21:'RI1tERVIEW DR RODUNK RIDGE
Addr. 75 COMMERCE WAY
SOUTH WINDSOR CT 06074
Phone No. (860)528-5252
The Drain Layer assigned tkYis perFast teasa]id license `issued by the
state and hereby agree ,.tb all the terms and condaigxi' set<:foth in the
attached 'Conditions' .'All' work sha15 b i abcordnce. Wi:th.Tawn of South
a17 OSHA re uirem nts aryl tie atta6he& 6q ditions.
Windsor standards,
Issued By
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Date Inspected „ ,;.:::..
---------------- Inspected By �,f
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 3
BUILDING ADDRESS 1410
STREET UL '
SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
(:D
4 4-
04
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 ��, r 1
TOWN OF SOUTH WINDSOR 5
PUBLIC WORKS DEPARTMENT
�� ` LA TOWN HALL �
-1 i� 1540 SULLIVAN AVENUE �a *0
SOUTH WINDSOR, CT
FEE $60.00 ;
C� Location of proposed work:_ CLA-A &- TJR i ( V Lot # 'R W, i ` (i,�'
�17 Street No. Street Name ( , l t�
Premises owned by: f i rd mLtdi"
Name of Firm: J Phone:
Address,of Firm: M A M A le �
TYPE OF WORK:
Lay House Drain Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with - t
Existing Water Supply: Public Water Well
Proposed Start Dated-- 4 -d Estimated time for completion Aug`
r`N
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 _ i the holder of D
Layer's License No. '7 ram
. 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 d9attached thereto. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No.
7 0
Signed: Print Name: ,,� T t
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc -