HomeMy WebLinkAboutDrain Layers Permit 95 Riverview Drive f �
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7668 Contractor J & H`SLATER CONST CO
Location 95 RIVERVIEW DR PODUNK RIDGE ::Ad4res i ?:::':_75 4"MERC"AY
Type Work NEW SAN LAT :OZI�H WINDSORT. 06074
Date Insp Needed Date Iris !S Q T
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Permit No. 7668 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 95 69,5.,] 21 1 SAT�lE-CHECK �!
Applicant Locek:ion
Name J & H SLATER CONS CO $1(icix 9S-;RIVERVIEW p12 PODUNK RIDGE
Addr. 75 COMMERCE WAY Owriex
SOUTH WINDSOR CT 0;6074
Phone No. (860)528-5252
The Drain Layer assigned tI]is ptitf 'hS a sraladcense`issued by the
state and hereby agrees to a1' the 'ermd and cdnditiort Set;:forth in the
attached 'Conditions' . A71 work sha b '- fin sCOrdaxtce With Town of South
Windsor standards, all OSFIA W. uiremIt. t `and. cue attaohed,:.ec.hditions.
Issued By _-- Title..:_ 1
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Date lc Inspected p --------------- I n spe C't ed By --------------------
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: '0-9-0.�
BUILDING ADDRESS : : o*,-
STREET
SUBDIVISION: AnL4ak 21 DL
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS . SIGNATURE
5 b u,-rl LJ)N h�v 2 /`t Ob�'� f Anti►, er_ p50 3 DATE
TOWN�� STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
19
'(to LA APPLICATION FOR DRAIN LAYER PERMIT ��`� _40
1 —70 TOWN OF SOUTH WINDSOR 5 qu
PUBLIC WORKS DEPARTMENT
TOWN HALL 141 -n-00
1540 SULLIVAN AVENUE �� ' 0
(e V SOUTH WINDSOR CT
(A FEE $60.00
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Location of proposed work: t �; Lot #_ �l; l : t I;�'
Street No. Street Name t i�{ T
Premises owned by:
Name of Firm: ph i
one.
Address-of Firm: uu"Aj
TYPE OF WORK:
Lay House Drain ; 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 Date 9- 8_--� Estimated time for completion ( ► ct, ►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 if-jZ the holder of Drain
Layer's License No. 26-1 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 d•attached thereto. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No.
Signed: Print Name: I.A
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc