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HomeMy WebLinkAboutDrain Layers Permit 43 Stevens Road • TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 7028 Contractor JMJ CONSTRUCTION CO. Location 0043 STEVENS RD Address 658 ELLINGTON ROAD Type Work NEW SAN LAT SOUTH WINDSOR CT 06074 Phone No. (860)528-7889 Date Insp Needed Date .Iosp. �/��/99 �_— Time Insp Needed / s 3 , m� Ins�s� .r�. , - — Inspected By A Work in Progress Ale Input = � Date .Perw t*--No. 7028 Town of South Windsor, CT P t-mk t TDate 07/28/1999 Drain Layer Permit -Expiration Date 08/27/1999 Descrip: Applicant Location Name JMJ3CONSTRUCTION CO. Addr.``,0043 STEVENS RD Addr. 658 ELLINGTON ROAD OwnetJMJ CONSTRUCTION COMPANY SOUTH WINDSOR CT 0F474 Phone No. (860)528-7889 The Drain Layer al'i d 1 i tense issued by the state and hereby agrees tc �)"'tk ert� . anti` ion iti hs set forth in the attached 'Conditions" ',. :� i :Work $ha'1 f E .i n a�cl br^dance with Town of South Windsor stand rds, a 1 i,--0,$"A re attached conditions. Issued B — Y Date Inspected �T�__ �nspe�t®d ey TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL. FIELD LOCATION DATE OF CONSTRUCTION: � BUILDING ADDRESS L 6� STREET + SUBDIVISION: z NORTH ARROW 10. 11,17 CDs F-T t3 , SjV�U C'cr s vL}7dnJ uz sw j /L- v/� CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT) STREET ADDRESS (: S ✓� �'©7� B % DATE TOWN STATE ZIP INS CTED T DATE TELEPHONE NUMBER WHITE - TOWN PINK CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER y APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT f TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Location of proposed work: S S Lot # Street No. Street Name Premises owned by: ,7 - Name of Firm: Phone:_ ' -� Address of Firm: TYPE OF WORK: Lay House Drain ; Repair House Drain Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with, -')P-7, Bs-- Proposed Start Date2^: 8 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 �/Y1,�'� a holder of Drain Layer's License No. a opq 30 ly holders of Pi, 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: —d'/Xo� Print Name:_ J© , ice Dr Layer- Date:. 2 �� Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc