HomeMy WebLinkAboutDrain Layers Permit 32 Stevens Road k
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7170 Contractor JACQUES CONSTRUCTION (JOHN)
Location 0032 STEVENS RD Address 67 RIDGE ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
Phone, ,,.No. (860)432-1823
Date Insp Needed
',"Date '-,Insp,,.= 60
Time Insp Needed �0. ... T Ime Insp
Inspected By - �
Work in Progress 9Qh_ r �`'irir /� nK. k ?-
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Input _^ �� Date
1:)eimt No. 7170 Town of South Windsor, CT
Permit Date 07/19/2000 Drain Layer Permit
Exp.ira�tion Date 08/18/2000
Descrfp: LOT 48 CK16743 $1233 . 37 CK16746 $183 . 33
Applicant Location
Name JACQUES CONSTRUCTION ( 3 �1 'Add'
r.° 0032 STEVENS RD
Addr. 67 RIDGE ROAD fi?wner JMJ '.CONSTRUCTION COMPANY
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SOUTH WINDSOR CT Y`064%4 ;
Phone No. (860)432-1823 „� `,z
The Drain Layer assiOrte, thl s parr' .has <i v, fi d 1`icense issued by the
state and hereby agraes" t4 III the ��` � and `c4n��t�ons set forth -in the
attached 'Cond i t i onsIWcrk. tl � n apo+ r�lnc with Town of South'
Windsor standards, al`7' C egi1 �.< d tt�e -,attached conditions.
Issued By
Date Inspected
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TOWN OF SOUTH ANDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS `D
STREET e veAs R o�
SUBDIVISION: PC(,/,+yj
NORTH ARROW
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J'Alil
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C0 TRACTOR (PRINT) NAME CT
O 'S ER VISOR (PRINT)
61- A*tl h 0
STREET ADDRESS f SIG RE
C-� �[� o '7 7
TOWN STATE ZIP INSPEob 6 TOWN
f)-_ a,/Z T DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
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: Lot #�
Street No. Street Name
Premises owned by:
Name of Firm: � 9` J�"'"�
Phone: gJ\ 6X2'-�
Address of Firm:
TYPE OF WORK:
Lay House Drain VZ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with 'TT
Existing Water Supply: Public Water Well
Proposed Start Date -7 I o0 Estimated time for completion
ALL WORK TO BE IN AC ORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CON ITIONS ATTACHED TO THE PERMIT
Permit is to be issued to 621 S L-." the holder of Drain
Layer's License No. OCT my holders of P1 or P7 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.
CBYD No.
s17-1
Signed: Print Name: "id
ice d D n Layer
Date: (�
Standard rms\P/rmits\APPUCATION FOR DRAIN LAYERS PERMIT.doc