HomeMy WebLinkAboutDrain Layers Permit 27 Stevens Road 1
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7070 Contractor JMJ CONSTRUCTION CO. ,
Location 0027 STEVENS RD Address 658 ELLINGTON ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
Phone No. (860)528-7889
Date Insp Needed /0/2� � Date :Insp. `ofZg / S�
Time Insp Needed € T i me F.hrysp€ ,
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Pei 'No. 7070 Town of South Windsor, CT
P�ermt Date 10/13/1999 Drain Layer Permit
,Expiration Date 11/12/1999
Descrip: CK16338FORPRO RATE FEE
Applicant Location
Name JMJ CONSTRUCTION CO. Actjjr. 0027 STEVENS RD
Addr. 658 ELLINGTON ROAD _ 0Wner JMJ ,>>CONSTRUCTION COMPANY
SOUTH WINDSOR CT 0$t74
Phone No. (860)528-7889 ,•`
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The Drain Layer assthis port t 1w has vat ?d license issued by the
state and hereby agr ss t� � tNe etr- and` c-0nditi ns set forth in the
attached 'Conditions' Al 3 �k a 7 3 1 n agGt�rd60c� with Town of South
Windsor stand rds, al1YOStfA qufrumen , ,end attached conditions.
Issued By
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Date Insp c ed _ 2 Inspetdd ,$y
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESSol
STREET ,-
SUBDIVISION: 77?qe-P�gac w _=
NORTH ARROW
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CONTRACTOR (PRINT) NAM OF CO TRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS
v - DATE
TOWN per` ` STATE ZIP INSPECTED BY TOW
06 �T DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Location of proposed work: Z 2 s�eC'Apo_r Lot #
Street No. Street Name
Premises owned by: !�
Name of Firm: -- - Phone: �o''dlq-%`�
Address of Firm: l�iG J2 161, 1��
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Proposed Start Date 0—/3''I Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH.TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDIT1 NS ATTACHED TO THE PERMIT
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Permit is to be issued to J�/ - I the holder of Drain
Layer's License No. O Only holders of P1, P7 & W9 licenses will
be issued a permit. Permit will pire 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: 16
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ice Dra' Layer
Date:'- �7_
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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