HomeMy WebLinkAboutdrain layer permit 18 Redrock Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7646 Cont:r.ae't'orACQiE;S.:CONSTRUCTION (JOHN)
Location 0018 REDROCK LANE Address a67 .RIDGE ROAD_
Type Work NEW SAN LATpUTH 'W->ZN€SSOg`>OT 06074
Phoawl.'p .(860)43�<L823
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Permit No. 7646 Town of South Windsor, CT
Permit Date 07/15/2003 Drain Layer Permit
Expiration Date 08/14/2003
Descrip: USER FEE PAID CK#16`0];:AT #12.59f::>..,..
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Applicant
liocat>ion
Name JAC UES CONSTRU tI,6N d5'
Addr. 67 RIDGE ROAD f"SOe CLARET_.<: EALTY INC
SOUTH WINDSOR ;C3�
T> Q� 'S�Q�74'
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Phone No. (860)432 1i2 ''' ;. ' ;.
rat..
The Drain Layer ..a >s Sed f tis y '' d 2cense`",1�sqkied by the
state and hereby ag et§lo Uo'�<€�1"l ;thex ter and cone �'TQ�'i�' se.&,.:fo.' in the
attached 'Conditions' . Allnl s ° ��r �lCe with Tpwn of South
" e aG`.t..ache& conditions.
Windsor standards, aln OSHA ;zequixenrtt}
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Issued By
Date Inspected Inspected B
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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 $60.00
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Location of proposed work: �� � �� � of #
Street No. Street Napg
Premises owned by: 6 vT reyo!�-L,
Name of Firm: - Phone: 'E �
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 S P 3 S'
Existing Water Supply: Public Water Well
Proposed Start Date Estimated time for completion
ALL WORK TO BE IN CCO DANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to �M— the holder of Drain
Layer's License No. 20 9 tii �IC2 ly holders of P-1, P-7 or W-9 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.
Sign Print Name: UCH J67 L -
Lice D i 6yer
Date C,
Standard Fortns\Pern i APPLICATION FOR DRAIN LAYERS PERMrr.doc
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• TOWN OF -SOUTH WINDSOR
SANITARY SEWER LATERAL F IELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET C 9cl )z c AiyF-
SUBDIVISION: T) FM I1y 6. . LL TaTE
NORTH ARROW
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CONTRACTOR (PRINT) NAME F CONTRACTOR'S SUPERVISOR (PRINT)
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STREETt,ADDRESS SI NATURE
• V r 11'1�S� {r- C..�� � � Q 7�f � - DATE
TOWN
/ STATE ZIP INSPECTED BY TOWN
` 0� "' O 6 O DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER