HomeMy WebLinkAboutDrain Layers Permit 103 Strawberry Lane f TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7653 Contractor WIY;COX=:CONSTRUCTION CO(DARRYL)
Location 103 STRAWBERRY LANE ddreasi; 535 OLtk.;.>$TIi'F.TORD ROAD
Type Work NEW SAN LAT pLLAMD=Cx; 0608:_
Rhone ft ( A)871 1:,$39
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Time Insp Needed Time Ixx?�p
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Input i Date
Permit No. 7653 Town of South Windsor CT
/ Permit Date 07/29/2003 Drain Layer Permit
Expiration Date 08/28/2003
Descrip: CK 1586 UNITS 101, 102, _l03 _$34:95.00 :;_>::
Applicant Location
Name WILCOX CONSTRUCTION) CO?DARRYL)_,. dd _103 :STRAWBERRY.. LANE
Addr. 535 OLD STAFFORDAZOAb. wn -
i
TOLLAND OT.; 0608
Phone No. (860)871-1839
The Drain Layer assigned this permit -.' a valid lace se slued by the
state and hereby agrees tc1 all tkt Cetms anti G9ndit:L set x'orCh in the
attached 'Conditions' .::A1J .w;i5xk sTralle „an aecadance +i.:th Town of South
Windsor standards, all:: OSItA xequS; ;ets�e3 t -, az: :the attached ct Aitions.
Issued By — —Txtl:e ------------
—
Date Inspected —_—......... _ _— Inspected
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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
Location of proposed work: o i, 5?,1Pt-0 w Lot # /�
Street No. Street hame
Premises owned by:_YU.11l
Name of Firm: Gvika X 66, 2TV e Phone:
Address.of Firms_ 5���^ �l� S'`�/`�a�� /P c✓ T�/1.���✓ To�jo��
TYPE OF WORK:
Lay House Drain Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with �� C
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 ATTACHED TO THE PERMIT
Permit is to be issued to 1:5 the h Ider of Drain
Layer's License No. ___?c ��T Only holders of P-1,0r 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: ���� �/
���i-Licensed Drain Layer
Date:
Standard Forms\Perm1ts\APPLICAJ10N FOR DRAIN LAYERS PERMIT.doc
•, TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL , FIELD LOCATION
DATE OF CONSTRUCTION: _ �7— 29-
BUILDING ADDRESS --tvo.vjL. ,,. L,_ 03101a 0
STREET
SUBDIVISION:
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CONTRACTOR (PRINT) NAME OF CONTRA TOR-S SUP RVISOR (PRINT)
STREET ADDRESS SIGNATURE
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-� DATE
TOWN STATE ZIP INSPECTED BY TOWN `
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER