HomeMy WebLinkAboutDrain Layers Permit 101 Strawberry Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7651' Contractor WILCOX CONSTRUCTION CO(DARRYL)
Location 101 STRAWBERRY LANE 7{ddress:. 535 qLD"STAFF.ORD ROAD
Type Work NEW SAN LAT TDi:LAND`C7. Ob084.,.
Phone 'No
Date Insp Needed Date-------------
In21
Time Insp Needed _____— __ _ Time IAA-pu �
Inspected By _.iT
f..
Work in Progi��ss � '� � � s �...<
,"_�
rr
JA
it
-- ----C�✓fi�CL� _L!=3tJ� /t/�f-:'+aj.rLnOY1� �s fo t�® rn�'U
e-47— r Wfl�� Input Date
i
Permit No. 7651 Town of South Windsor, CT
Permit Date 07/29/2003 Drain Layer Permit
Expiration Date 08/28/2003 �!
Descrip: CK 1586 UNITS 101, 1..:02 103 $ 495 ..00
/'...
I
Applicant Location
Name WILCOX CONSTRUCT�-'ON 60'(;DARRYI. AS�f fi a .:101 STAAWS4ARY-LANE
Addr. 535 OLD STAFFORD ROAD 05471e.r
TOLLAND C:T 0608;4
Phone No. (860)871 1639
I
The Drain Layer 'as`szgned:. this 1tt3 has a. *rTzd �ieense �s,sued by the
state and hereby agrees to-a11 the terms and crrnditaon t forth in the
attached 'Condit ons" .:ivoxk sh i b! 351 a ordan,Ce with Town of South
Windsor standards, aI`l OSHA requirements aid the attadTiee conditions.
Issued By -- — TxCJ2R—
'------------------
� ZLI—
Date Inspected Insspea ed By __
s
7 G�1
• APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: lo/ f'I`�'i �i�j���f/ Z^ Lot #
Street No. Street Name
Premises owned by: �v,�`,�Y�ir 7Vvu/v /
Name of Firm:_ e'a1 ����s �'c tic' Phone:
Address.of Firm:,_5�7J^
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 L' Well
Proposed Start Date ? Estimated time for completion .J::G' � Yf
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
the holder of Drain
Layer's License No. 0e?79X . Only holders of P-1,0 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.
Signed;. Print Name:
Licensed Drain Layer
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: �-
BUILDING ADDRESS 5 �•��u%���,,..... L � i r t; ����J
STREET
SUBDIVISION: h1
NORTH ARROW
-fu'
1 7y
' 3
! � t
`
LkA ,
t
la
I I 4-
- t t
• a
, j
1 -
i
,.,._. i r--_._..�__..- _ __f....__ 1 .. __.... c.-.. �_.. � _ -_.fit% f'�_`�-fi^��.� ��.Z ✓��_. �_...._ + {..— _ a_.. i..__.
t ;
{
I a
i
CONTRACTOR (PRINT) NAME OF CONTRA T R'S SCUP LRIISOR (PRINT) 1
STREET ADDRESS SIGNATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER