HomeMy WebLinkAboutDrain Layers Permit 78 Riverview Drive TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7666 Cont..xaeCtir J '&""H`°SLATER CONST CO
Location 78 RIVERVIEW DR PODUNK RIDGE Att'dressi; €":;€75 QQMMERC `:WAY
Type Work NEW SAN LAT SOUTH W'IN:ASOR CT 06074
Phone.No .($ Q}528 52.52
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Date Insp Needed Date Znap ?3
Time Insp Needed Time Itisg, /tee
Inspected By �L�.
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Permit No. 7666 Town of South Windsor, CT
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Permit Date 09/22/2003 Drain Layer Permit
Expiration Date 10/22/2003
Descrip: FEES FOR 28,36,40 70- 78 54..,95 69 1 21,1:_:SAME CHECK �9
Applicant
LOP. ion
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Name J & H SLATER CON8'T CO - Ar d;x 7& :RIVERVIEW ,I. PODUNK RIDGE
Addr. 75 COMMERCE WAY Otrrer
SOUTH WINDSOR CT 06014
Phone No. (860)528-5252.
The Drain Layer asslg3y d this p i j. x hr4 a xr lid license <ass.0 by the
state and hereby agree$ to r I`: the tCrms" 'Yfd coh" t�aiX# Set_,..forth in the i
attached 'Condition --dill work sha th Town of South
Windsor standards, all OSHA ,requirem zits, :arid the attached., zouditions.
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Issued By --------- �� i tie
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Date Inspected — Inspected"By4J' `^ 5
TOWN OF SOUTH WINDSOR
SANITARY : SEWER LATERAL FIELD LOCATION
DATE OF 'CONSTRUCTION:
BUILDING ADDRESS
STREET 10c--/?-L/ ptL VC
SUBDIVISION: /Z D
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTORS SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
_�bV.7N l:J!iJll�e10� b(,D7Zf46o DATE
TOWN STATE ZIP INSPECTED BY TOWN
g6 DATE
TELEPHONE NUMBER - :
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
APPLICATION FOR DRAIN LAYER PERMIT �4 -40'5' TOWN OF SOUTH WINDSOR 6
�� PUBLIC WORKS DEPARTMENT
TOWN HALL �tA `
� ULP-A 1540 SULLIVAN AVENUE
v °� SOUTH WINDSOR CT
FEE $60.00 \ �
(P f LoIL
cation of proposed work: EuA d6 n iA l �V Lot # , �, 5- �, ��
Street No. Street Name Z, lq�t 7 2,- T
Premises owned by: ZS co
Name of Firm: J;r- Phone:
Address-of Firm: IS ®ztfV Ww'-j WAJ
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• Z -63 Estimated time for completion fit(.fiN y 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. Z'I 19a 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: Jtt d'
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc