HomeMy WebLinkAboutDrain Layers Permit 36 Riverview Drive •
� TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7663 Contract` r J....
&. SLATER CONST CO
Location 36 RIVERVIEW DR PODUNK RIDGE „Ad res::s; €`^:;'' 75 COMMERCE`=::WAY
Type Work NEW SAN LAT ,OUTH WINDSOR CT 06074
13:hone Teo (8: 41528`5 ,52 :.
Date Insp Needed Date Iris
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Permit No. 7663 Town of South Windsor, CT
Permit Date 09/22/2003 "" Drain Layer Permit
Expiration Date 10/22/2003
Descrip: FEES FOR 28,36,40,74>`;78, 4';:,9`5' 69,5.1 21, e;SA-ME CfiECK
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Applicant LodaC=ion
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Name J & H SLATER CONST.CO 12IUERVIEW DR T�.ODUNK RIDGE
Addr. 75 COMMERCE WAY -` Ovgrier.
SOUTH WINDSOR CT. 06024
Phone No. (860)528-5251,),
The Drain Layer aSs3`grxed this e �vt5t his a u:alsd- kicens'e assted by the
state and hereby agree.O- -1 the 'terms''`a'nd con ditLk set forth in the
attached 'Conditions' .. A11 wr�: k shallexs aGordarie with Town of South
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Windsor standards, all OSHA xequiremt ts, and-.the at:taChed..Conditions.
Issued By �_ � " Tita":
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Date Inspected Tns'percte`d -By
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION;
BUILDING ADDRESS
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
S Go Y%m C,2CG- �9
STREET ADDRESS SIGNATURE
n vt-o4 Gr b�D�/ �.a.C� 9�L�, DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
(0&2
APPLICATION FOR DRAIN LAYER PERMIT �'� V�5 0
TOWN OF SOUTH WINDSOR 5°
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT M
FEE $60.00 it
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1 Location of proposed work:_ ,� ; T-0 14 . A� Lot #_
U 17- Street No. Street Name ( i i
Premises owned by: (
Name of Firm: J�r tCe Phone:
Address-of Firm: T AC1 I�
TYPE OF WORK: /
Lay House Drain I✓ 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 Dateq-Z3-(33 Estimated time for completion tb14'14
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 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. i and/or ConnDOT Permit No.
CBYD No.
Signed: Print Name: L ,, - �
Licensed Drain Layer -
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc