HomeMy WebLinkAboutDrain Layers Permit 48 Riverview Drive A
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7680 Cont.-adtor J & a-SL-. TER CONST CO
Location 48 RIVERVIEW DR A3dressp 75 ; OMME.RCt%.WAY
Type Work NEW SAN LAT :.OUTH WINDSOR C:x 06074
Phone 'Iqd C66::b)5.2$:"52.52
Date Insp Needed Irate trip 3
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Time Ins Needed
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Permit No. 7680 Town of South Windsor, CT j
Permit Date 10/22/2003 Drain Layer Permit
Expiration Date 11/21/2003
Descrip: CK 10900 $6639.00 SIX PERMITS $36 00 CASH
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Applicant 0.0 ion
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Name J & H SLATER CONST CO Addt. B:I�IVERVTW DI2
Addr. 75 COMMERCE WAY_ OWher RSK KEI,LCO
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SOUTH WINDSOR CT..`06O74
Phone No. (860)528-5�52. i
The Drain Layer assigned-Gl�s pss3b has a ualad l: cenae assued by the
state and hereby agrees tq' l .the Eerms and ctirtditao.ns set; forith in the
attached 'Conditions' : 1511 wo3t still bes yec'ordan 'e with Town of South
Windsor standards, ail OSHA requirem�n�s - and.the att'aChed ..conditions.
Issued By T�.tle �- *
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Date Inspected --------------------- Ifispe'd°CecY"By ____--
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�680
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:-I,-,Ow 4�1L ��
Ct Lot #/C�. _
Street No. Street Name
Premises owned by: KJ(-k-M
Name of Firm: J.` 14 S tam-- ��s� I�C• Phone:
Address.of Firm:_
TYPE OF WORK:
Lay House Drain k Repair House Drain
Lay Main ; Lay Laterar for Commercial/Industrial
Building of acres
Connection will be made with bK P�C.
Existing Water Supply: Public Water Well
Proposed Start Date_ LL- -65 Estimated time for completion
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 J,U3, St A-,C-Z the holder of Drain
Layer's License No. 767-714 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 an attached thereto. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No.
Signed: Print Name: J PCs a sv+;�
Licensed Drain Layer
Date:—( ZZ-03
Standard.Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY - SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: oL4
BUILDING ADDRESS LZrt
STREET . he -I
SUBDIVISION: rJ It
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NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
"7 5 LatttmC(Lc wAy
STREET ADDRESS SIGNATURE
o,T IJ1rlb CT' 0�074 DATE
TOWN STATE ZIP INSPECTED BY TOWN
'T6 0. " 5 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER