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HomeMy WebLinkAboutdrain layer permit 31 Lavender Lane 1000019 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER DRAIN LAYER PERMIT DATE: 05/10/10 o GIS ID: 52600031 �� MUNIS APPLICATION# 201000527 ��� 1y FEE: 60.00 FEE: DATE: 06/09/10 APPLICAN 3 NAME: JACQUES CONSTRU T O ) LOCATION ADDRESS: 67 RIDGE ROAD LAV ER LANE SOUTH WINDSOR,(� � = � TRUCTION CO INC Qy . rHLI� GTON ROAD PHONE = `�V INDSOR CT 06074 860-432- � ' VA T WORK DESCRIPTION: NEW SE A� .. THE DRAIN LAYER ASSIGNED TO THIS P _ s THE TERMS AND CONDITIONS SET FORTHA�S J5 TATE AND HEREBY AGREES TO ALL THE TOWN OF SOUTH WINDSOR STANDARD 5 TI RK SHALL BE IN ACCORDANCE WITH � Tg ATTACHED CONDITIONS. 2 T ISSUED BY DATE INSPECTED INSPECTED BY 5/10/2010 9:33 AM -.. ... __...__...-..... - ----------------------..._-.... _ - y ' jol . - j` TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO. / 00'90/ l CONTRACTOR: ze LOCATION: TYPE OF WORK: DATE INSP NEEDED: DATE INSP: -7 INSPECTED BY: - $b WORK IN PROGRESS: pro*1 -6. Fro g- •�' {hair ao,��a �n �,D-�,.e ,��h�I; sL � TAPS SEPTIC TANK PUMPED, S ASHED, FILLED WITNESSED ❑ YES El NO AS-BUILT: INPUT:- Coll'` DATE: t '� W/2007 Town of South Windsor INPSECTION REPORT 07 APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR - PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $60.00 Ll .Location of proposed work: L . 1,1n1'01X).S7 Lot # Street No. Street Name - Premises owned by: --T- 6 J 600 5-1t Name of Firm: Phone: JAW A 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 Existing Water Supply: Public Water Well Proposed Start Date ! Estimated time for completion ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS, ALL OSHA REQUIREMENTS AND CONDITIONS A ACHED TO THE PERMIT Permit is to be issued to � 'a Ca v� �'O the holder of Drain Layer's License No. DO gA20 0 y holders of P-1. P-7 or W-9 licenses will be issued a permit PERMIT WILL EX IRE 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. Signed: Print Name: J©�o� C L) Lice Dr I Layer Date: a Standard FO Peimit WPUCATION FOR DRAIN LAYERS_PERMIT.doc TOWN OF SOUTH WiNDSOR SANITARY SEWER LATERAL-�, FIELD LOCATION DATE OF CONSTRUCTION: / D BUILDING .ADDRESS STREET 3 . er � SUBDIVISION: � � er f Ps NORTH ARROW 14/ 19 ON e- '4 Y) C0,15t -it- Cat--e CONTRACTOR (PRINT) NAME F CONTRAC S ERVISOR (PRINT). /0 .5-F Ellf,� 'Q )104 )e oad STREET ADDRESS / S GNATURE i S o V C-T 0 b z DATE TOWN STATE ZIP INSPECTED BY TOWN DATE TELEPHONE {NUMBER WHITE --TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER