HomeMy WebLinkAboutDrain Layers Permit 11 Stevens Road 'I
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7078 Contractor JMJ CONSTRUCTION CO.
Location 11 STEVENS RD
Address 658 ELLINGTON ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
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Phone No. (860)528-7889
Date Insp Needed Date,jnsP•
Time Insp Needed i'
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Inspected By
Work in Progress
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Input Date
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P,e mvt No. 7078 mown of South Windsor, CT
Permit Date 10/25/1499 Drain Layer Permit
Expi r-"a1;1 on Date 1 1/Y4/1 t99--
Deaj�r i p:N.
Appli�;nt �
?' .. �� Location
Name JMJ CONSTRUC1ON Actdr 1 STEVENS RD
Addr. 658 ELLINGTON� ROA[� �tner .JMJ CONSTRUCTION
SOUTH WINDSOR CA ,
Phone No. (860)528-7889
The Drain Layer a ih'fs p t has vat ii. lei cense issued by the
� `£ 1 the ermF and cct�ti ohs set forth in the
state and hereby agrees irk
attached 'Conditions �OJk sh .l n a 6ofrinc with Town of South
Windsor standards, al',1 r:0S�,,¢l t 7 t"t n end h attached conditions.
Issued By, il _
CNA
Date Inspec d Z10 1149 Inspected "8y _
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR �1
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00 -
Location of proposed work:_f S > 5 Lot #
Street No. Street Name
Premises owned by: M.3
Name of Firm: Phone:
Address of Firm: S� ' 08 CL
TYPE OF WORK:
Lay House Drain V ; Repair House Drain
Pa ,
Lay Main Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with S DR, ::�
Proposed Start Date- Q 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 the holder of Drain
Layer's License No. 230 - my holders of P1, P7 & W9.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 and attached thereto. Applicant has received Town Street Excavation
Permit No. and/or ConnDOT Permit No.
Signed: Print Name:!
License rai yer
Date: f�2 z9,T-9?
Standard Formwermits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: .A`fi�/ i 9�
BUILDING ADDRESS .
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STREET
+ SUBDIVISION: pin
NORTH ARROW
444
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CONTRACTOR (PRINT) , NAME OF CON TOR'S SUPERVISOR (PRINT)
STREET ADDRESS SI
/0 /� ?ATE
TOWN STATE ZIP INSP CTED 0 N
O�a DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER