HomeMy WebLinkAboutDrain Layers Permit 94 Riverside Drive C g
TOWN OF SOUTH WINDSOR INSPECTION REPORT (.
Permit No. 7667 Contr�or J &`'H""SLATER CONST CO
Location 94 RIVERVIEW DR PODUNK RIDGE A3dressi; =':::;75 MERCE`'WAY
Type Work NEW SAN LAT �.OUTH I9-INDSOR CT 06074
Phone No .(8�Q)528-5252 :.
Date Insp Needed Date Insp
Time Insp Needed
Inspected By
Work in Progress
Input: Pala-�
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Permit No. 7667 Town of South Windsor, CT
Permit Date 09/22/2003 Drain Layer Permit
Expiration Date 10/22/2003
Descrip: FEES FOR 28,36,40,70 78,94,45 69,5,�,,21,1 SAME,CHECK
Applicant Location
Name J & H SLATER CONST CD Addr 94.RIVERVIEW DR PODUNK RIDGE
Addr. 75 COMMERCE WAY 0 *ner
SOUTH WINDSOR OT" O;074
Phone No. (860)528-5252
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The Drain Layer assigned this C.- .kkas a v alid l Iq:6 6e rssued by the
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state and hereby agreeb 0 a;�l .the"terMs and ctiri'dit1oris set;:_fox'th in the
attached 'Conditions] All work shalj k3& YL acbrdanca with Town of South !
Windsor standards, all OSHA rQ'quirem xats _anl-.tie attached::.Conditions.
Issued By Gt Title
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Date Inspected Insped ed By /-`
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: o3
BUILDING ADDRESS l�11J
STREET : 41 yar, v
SUBDIVISION: Pao)
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTORS SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
�,x'H ►� t.J b5o 1� e ®�i fi 1 y DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE 'NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
1(.0 APPLICATION FOR DRAIN LAYER PERMIT 45
v,c� TOWN OF SOUTH WINDSOR 5
PUBLIC WORKS DEPARTMENT ' $
�L TOWN HALL 4 -A
1540 SULLIVAN AVENUE del
'I fP V SOUTH WINDSOR, CT 1 f�
-I (e FEE $60.00
(� f Location of proposed work:_ 6uA dr,n r-J, A A y Lot #_ -5 I s- t� �' c
1, �.
Street No. Street Name ( , ( �i
Premises owned by: ZS C Ka-1--co S u fi PA.
Name of Firm: Phone: 8 , SZSL
Address.of Firm:_ 06.) to 1A g
TYPE OF WORK:
Lay House Drain Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
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Connection will be made with
Existing Water Supply: Public Water Well
Proposed Start Date 9- Z -(3 Estimated time for completion Ot 6 T O
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 the holder of Drain
Layer's License No. Z61-L . 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: Jpt t 5unn?__
Licensed Drain Layer
Date:
Standard Forms\Permlts\APPLICATION FOR DRAIN LAYERS PERMIT.doc