HomeMy WebLinkAboutDrain Layers Permit 701 Dzen Way M
TOWN OF SOUTH WINDSOR INSPECTION REPORT
e �
Permit No % 7445 Contractor WILCOX CONSTRUCTION CO(DARRYL)
Location Address 535 OLD STAFFORD ROAD
Type Work NEW SAN LAT TOLLAND CT 06084
No. (860)871-1839
I
Date Insp Needed s ®�
Time Insp Needed AAJ
i
Inspected By
Work in Progress
drq%w it
S r >
z &
SOR- 60 Date
W 4_, 1 a
Permi-C* 7445 Town of South Windsor, CT
Permit Date 06/10/2002 Drain Layer Permit
Expiration Date 07/10/2002
Descrip:
Applicant Location
Name WILCOX CONSTRUCTION C DV14 0 DZEN WAY
Addr. 535 OLD STAFFORD RO U VAN TOWN HOMES LLC
TOLLAND CT
Phone No. (860)871-1839 - -
The Drain Layer a sla s as 1 cense issued by the
state and hereby agr h nd io s set forth in the
attached 'Conditions' .*Ai a with Town of South
Windsor standards, al q ached conditions.
Issued 8y _ '
Date Inspected SO 0 y
I Jf1(/J1
V
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: �o ���Y (mow � Lot #
Street No. Street Name
Premises owned by: �•��&,&/
Name of Firm: yeae oe /ycv Phone:
Address of Firm: 21V felzpf� �h/•mac/ G'Q`--
TYPE OF WORK:
Lay House Drain; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with //�dG✓
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 z2/1/710/` .c C�� Ca
/" the er of Drain
Layer's License No. , 7a0 ��� . Only holders of P1 o P7 ' enses 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 ame: ,�/rn41�"&,0,u/`� 1,✓
Licensed Drain Layer
Date: o Iev 2
Standard;Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
r
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL, -FIELD LOCATION
DATE OF CONSTRUCTION: 17- o Z
BUILDING ADDRESS ?01. 70��03
STREET : 0 w�
SUBDIVISION:
NORTH ARROW
I •
c �
1
. I
!_..__�_. _
' f i _�_ _•1 i - -I-_- - -�-- —f
10
f h
t�t
1 •
CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR PRINT
�tI3.JLLX
STREET ADDRESS SIGNATURE
� CT to T.�i.iy� -A DATE
TOWN STATE ZIP INSPECTED BY TOWN
g'7 l 3 DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER