HomeMy WebLinkAboutDrain Layers Permit 4 Chapman Circle i
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 6645 Contractor WILCOX, MICHAEL
Location 0004 CHAPMAN CIRCLE Address EAGLE EARTHWORK SERV.
Type Work NEW SAN LAT 101 N MOUNTAIN ROAD
CANTON CT 06019
Phone No. , (860)693-2027 j
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Date Insp Needed � -/� Date- Insp.,
Time Insp Needed 9 �� �' Time Insp. _. _
Inspected By
Work in Progress , 5 _.>�%' �. • ! �-
Input 's . �_.° Date
Permit No. 6645 Town of South Windsor, CT
Permit Date 07/15/1997 Drain Layer Permit
Expiration Date 08/14/1997
Descrip : LOT 21 AVERY MEADOW
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Applicant " Location
Name WILCOX, MICHAEL Addy. 0004 CHAPMAN CIRCLE
Addr. EAGLE EARTHWORK SERV "'Ow ,,kANNARINO BUILDERS INC
101 N ,MOUNTAIN ROAD
CANTON CT .,06019 ' f
Phone No. (860 )693-2027
The Drain Layer ass i,gned t; ,J s perFmi t has a val l d^ 11cense issued by the
state and hereby agrees to �al1 the terihs And ce a:t:ions set forth in the
attached 'Conditions' . A11 , work. shall be ineaccprdane`e with Town of South
Windsor standards, all OSHA requirements, and :the attached conditions.
Issued B
Tit
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Date Inspected __ .� c_ ___ Itis�►e�tedBY __TL�� _
APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work: C' Lot # Zf
Street o. /Street Name
Premises owned by: /16 Ce stab ' ok
Name of Firm: S E Q Phone:
Address of Firm: D Room <C
TYPE OF WORK:
Lay House Drain Repair House Drain ;
Lay Main Lay Lateral for CommerciaVIndustrial
Building of acres
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Connection will be made with
Proposed Start Date 2 16 Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR
STANDARDS, ALL OSHA REQUIREMENTS. AND CONDITIONS ATTACHED TO
THE PERMIT
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Permit is to be issued torco dC the holder of Drain
layer's License No. Z7$jl Only hotaers-of Pl, 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.
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Signed: �'C/ Print Name R"a �
Licensed Drain Layer
Date: �� �1