HomeMy WebLinkAboutDrain Layers Permit 503 Dzen Way TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. Contractor WILCOX CONSTRUCTION CO(DARRYL)
Location � r Address 535 OLD STAFFORD ROAD
Type Work NEW SAN LAT TOLLAND CT 06084
a No. (860)871-1839
s
Date Insp Needed will C Iis
Time Insp Needed '
Inspected By
Work in Progress
f fill
Date
Perin. 7411 -town of South Windsor, CT
Perm'i.t Date 04/23/2002 Drain Layer Permit
Expi-ration Date 05/23/2002
Descrip:.
Applicant Location
Name WILCOX CONSTRUCTION CO.( SRFYLp dr. DZEN WAY
Addr. 535 - OLD STAFFORD ROA � ` UL VAN TOWN HOMES LLC
TOLLAND CT 0 .
Phone No ( 860)871-1839
The Drain Layer a s s as i 'cense issued by the
state and hereby agr� . - nd s set forth in the
attached Conditionsg. n a with Town of South
Windsor standards, al ached conditions.
Iseued By
4401
Date Inspected v- s
3. 4 74,fr
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: "5--® Z Lot #
Street No. Street Name
Premises owned by:�Sr,��< �/ j o��/ A,�A----S'
Name of Firm: ZI�IIAIX 0owrl— a xit c° Phone:
Address of Firm: olol
TYPE OF WORK:
Lay House Drain / ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of - acres
Connection will be made with r/
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,��2raGG ,max the holder of Drain
Layer's License No. .2aPcT . Only holders of P1, 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.
Signed:.12E�Lc Print Name:
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMrr.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: kU-2 6- a 2
BUILDING ADDRESS c 3 D Z c"t., 4iz!2 ,
STREET Sp /J zc.� G✓a..
+ SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
S;S �
STREET ADDRESS SIGNATURE
To Ito. c,7L G 1p Q?04i DATE
TOWN STATE ZIP INSPECTED BY TOWN
1_& DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER