HomeMy WebLinkAboutDrain Layers Permit 28 Riverview Drive r
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Perldit No. 7662 Contractor J & H `SLA.T_ER CONST CO
Location 28 RIVERVIEW DR PODUNK RIDGE 3ddrei "`::`.75 Cf3.MbIRCE°}WAY
Type Work NEW SAN LAT SOUTH WiN:6.SOR M. 06074
Phone No (&fib)52.8 "5252
Date Insp Needed Dates y:nsfttd
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Time Insp Needed mime Il's 0
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f Permit No. 7662 Town of South Windsor, CT j
Permit Date 09/22/2003 Drain Layer Permit
Expiration Date 10/22/2003
Descrip: FEES FOR 28,36,40 70:; 58 94y9'S 69 51 21 1 SAME CHECK
Applicant Lpc'a£aon
Name J & H SLATER CONST ;:CO Adtx 2 T�TVERVIEW DR PODUNK RIDGE
Addr. 75 COMMERCE WAY OS+ner
SOUTH WINDSOR CT.:.060 A
Phone No. (860)528-552::,.
The Drain Layer asssgne 7��s p rmxt his r Ixd liee ss aS14 by the
state and hereby agxes tol the berms°and condxtaons set forth in the
attached 'Conditions' <>A11 wc�xk sh'al . ba.;� aCaordana with Town of South
Windsor standards, alI OSHA re iYem ritsi and-title coxiditions.
Issued By -----�=--'-`- TrCl.e - -- -----------------
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Date Inspected In 8lrected''By _� E!`------E--- ---
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TOWN OF SOUTH WINDSOR
SANITARY. - SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: -
BUILDING ADDRESS : h Lrrl3
STREET - GP-VI G yc�;
SUBDIVISION: uNk �
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR(PRINT)
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STREET ADDRESS SIGNATURE
CG�� } DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
1(e(�N , 0 APPLICATION FOR DRAIN LAYER PE ;\ 5
40
1 u(09 TOWN OF SOUTH WINDSOR PERMIT 5 r
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-IS PUBLIC WORKS DEPARTMENT ��
c T ,�`� /11
TOWN
N HALL ,
1540 SULLIVAN AVENUE tag 00
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: C-LkA d� n tJ 1 A9 Lot
U 17-" Street No. Street Name ( , I �i 4
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Premises owned by: { 0.kt dfi3
Name of Firm: ilf-4 f Phone:
Address.of Firm: (�,� �hrj L/6 A-1
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 Dateq-Z3,33Estimated time for completion ( �t(b1�i';1•�
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 S_ W the holder of Drain
Layer's License No. 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 d,attached thereto. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No.
Signed: Print Name: �t -
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc