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HomeMy WebLinkAboutDrain Layers Permit 100 Collins Crossing TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 6888 Contractor WILCOX CONSTRUCTION CO(DARRYL) Location 100 COLLINS CROSSING Address 535 OLD STAFFORD ROAD Type Work NEW SAN LAT TOLLAND CT 06084 Ptro.,0� No. (860)871-1839 Date Insp Needed �6; , D te„ Ins 3 4 Time Insp Needed I Tim; In . zrl� gn„ Inspected By C! i I� Work in Progress D e 4 , I; I i i inp,ut -j Date _t_ b be Permit No. 6888 Town of South Windsor , CT -Perifff't' Date 09/30/1998 Drain Layer Permit E`xp i rat-i on Date 10/30/1998 3 Descrip: Applicant Location wee Name. WILCOX CONSTRUCTION CO,Dr 00, COLLINS CROSSING Addr. 535 OLD STAFFORD ROAD M ENTERPRISES TOLLAND CT -66O84 Phone No. (860)871-1839 The Drain Layer assigned th3�s p rrni was 'i( y r. i-d I iicense issued by the state and hereby agreos� to 431 `the i enift and bn itibn�s set forth in the attached 'C o n d i tions ,AI wor k shd1:1 b 1p accr r'c aflo with Town of South Windsor stand rds, al l; OSHA- *6quir', nth., i rid the attached conditions. Issued By Date Inspe t d t' 11�� s �fi . TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL :FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS STREET + SUBDIVISION: NORTH ARROW Ne i , I , , i , r ! I t S 1 , t_ i t t t f - i 1 � 1 , L q { r i f1A2f?F- GG 2 LJ�rt,v CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT) S3 S o Jcl STREET ADDRESS SIGNAT RE DATE TOWN STATE ZIP IN PEC D �7�- l�'3� DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER APPLICATION FOR DRAIN LAYERS PERMIT TOWN OF SOUTH WINDSOR (g PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE$25.00 Location of proposed work ©p" � ° �. f :r. Lot # _ Street No. Street Name Premises owned by: sj 1;r Name o `f Firm: ,l��c� � � l' " �� ,cctrc' Phone. n Address of Firm:. ` . �� 57f- / ar✓��✓ ,r�� c✓ �a�U,� ' TYPE OF WORK: Lay House Drain Repair House Drain Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with Proposed Start Date q_estimated time or completion � ` f p 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 Z�1 1 l -? the holder of Drain layer's License No. Only holders of Pl 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:� ` Print Name, �!'� '�� Licensed Drain Layer Date: ,�G