HomeMy WebLinkAboutDrain Layers Permit 40 Riverview Drive TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 7664 Contra J & H 'SLATER CONST CO
Location 40 RIVERVIEW DR PODUNK RIDGE .::Addresis 75 G'Q3NMERCE`WAY
Type Work NEW SAN LAT SOUTH WTNnOR CT..; 06074
Phone. No ( .`:-:. 528 :5252
Date Insp Needed Date Tns�
Time Insp Needed Tame IY# f .
Inspected By -
Work in Progress C64
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Permit No. 7664 Town of South Windsor, CT
Permit Date 09/22/2003 Drain Layer Permit
Expiration Date 10/22/2003
Descrip: FEES FOR 28,36,40 7q 78 94,;95 69,5>1,21,1" SAME ,CHE;CK
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Applicant Lpcti,on
Name J & H SLATER CONS_T Co
G1d3K �} 1.:=.RIVER,3IIW bR PODUNK RIDGE
Addr. 75 COMMERCE WAY;
SOUTH WINDSOR CT.,.06074,'.,
Phone No. (860)528-5252.:
The Drain Layer assigned Chas per �Z has a vlad 1:aense issued by the
state and hereby agrees 'to a3i the terms and coridit3�ns st.:: orth in the
attached Conditions' . All wozk shT1` :' Gordance.,orith TozSn of South
Windsor standards, all.. x•equiremen�a-r... �1d. he atC'aEhed.;:cosiditions.
Issued By
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Date Inspected
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I ns pe c t ed By ----------
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 3
BUILDING ADDRESS : ' o Lo-r H
STREET 6o b
SUBDIVISION: UN k 6
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
25 Co ,,.6-
STREET ADDRESS SIGNATURE - l
DATE
TOWN TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
�Cet2 APPLICATION FOR DRAIN LAYER PERMIT \�y 040
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
GALA TOWN HALL n
1540 SULLIVAN AVENUE as 0 AA
(�U 9 SOUTH WINDSOR, CT
-I le� FEE $60.00
Location of proposed work: dG-M rJ A pt Lot # 5, , !S j 8,j, l I \S\
Street No. Street Name (z, lq,i
Premises owned by: ZS t:� " re_Lc,O c AVAdrry FAI4,
Name of Firm: J r9 oc Phone: SZ8 SZS
Address.of Firm:_��
TYPE OF WORK:
Lay House Drain V Repair House Drain
Lay Main ; Lay Laterar for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water Well
Proposed Start Date—q- 7-5-03 Estimated time for completion f 11i.61ho
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 IV, 5[4 ifi-L the holder of Drain
Layer's License No. 26"1,1 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 attached thereto. Applicant has received
Town Street Excavation Permit No. Ill A and/or ConnDOT Permit No.
CBYD No.
Signed: Print Name:
4Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc