HomeMy WebLinkAboutDrain Layers Permit 501 Dzen Way y TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 7 09 Contractor WILCOX CONSTRUCTION CO(DARRYL)
Location Address 535 OLD STAFFORD ROAD
Type Work NE TOLLAND CT 06084
ne No. (860)871-1839 fll
Date Insp NeededIQ s ,
Time Insp Needed
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Inspected By
Work in Progress
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- ? Date
Re001t No. '�, 7409 "Down of South Windsor, CT
Per"mit bate 04/23J2002 Drain Layer Permit
Expiration Date 05/23/2002 I
Descrip:
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Applicant Location f
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Name WILCOX CONSTRUCTION Co -e' 1lL �d r DZEN WAY
Addr. 535 OLD STAFFORD ROA � � UL VAN TOWN HOMES LLC
TOLLAND
CT
Y_Phone No. (860)871-1839
The Drain Layer a s '` s as 1 'cense issued by the
state and hereby agr .'a nd s set forth in the
attached 'Conditions' . '1 k n a n with Town of South
Windsor standards, al ( ched conditions.
Issued ByFICNA
Date Inspected S s
3
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Location of proposed work;Sd/���y/��y Lot #
Street No. Street Name
Premises owned by:
Name of Firm: �IrG/ eaoc(X,-" Ali /:2r7&-` Phone: / �8
Address of Firm: CT: 5 el .S'T� /=a.2 /�� i�`r �✓ GT`p��y
TYPE OF WORK:
Lay House Drain_; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with u
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 the holder of Drain
Layer's License No. -26 Only holders of P1j(6�& 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: � �G
Licensed Drain Layer
Date:��? � /od1
\ Standard FormsWermits\APPLICATION FOR DRAIN LAYERS PERMIT.doc ��
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 2-
BUILDING ADDRESS : Sol w
STREET
+ SUBDIVISION: F,ttjl
NORTH ARROW
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CONTRACTOR (PRINT)) NAME OF CONTRACTORS SUPERVISOR (PRINT)
J 3 s ou ,j RA
STREET ttADDRESS SIGNATURE
r\�a1 � (3(oo � DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER