HomeMy WebLinkAboutDrain Layers Permit 702 Dzen Way TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7446 Contractor WILCOX CONSTRUCTION CO(DARRYL) �
Location l ' Address 535 OLD STAFFORD ROAD
Type Work NEW SAN LAT TOLLAND CT 06084
he No. (860)871-1839
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Date Insp Needed
Time Insp Needed 0 ; .
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Inspected By
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Permit# 04, 7446 Town of South Windsor, CT
Permit"tate '06/10/2002 Drain Layer Permit
Expiration Date 07/10/2002
Descrip:
Applicant Location
Name WILCOX CONSTRUCTION C D.T r 0 DZEN WAY
Addr. 535 OLD STAFFORD ROA U VAN TOWN HOMES LLC
TOLLAND CT s
Phone No. (860)871-1839
The Drain Layer a s s as cense issued by the
state and hereby agr e nd s set forth in the
attached 'Conditions' . 1 r a with Town of South
Windsor standards, al q ached conditions.
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Issued By
Date Inspected e y """"'`
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 42�e 6,,y G-� Lot
Street Nio. Street Name
Premises owned by:
Name of Firm:�.c/!�r-�i' Gp� ri Gam' e' Phone:
Address of Firrn:� ,t���C/
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with f!15" I�rA
Existing Water Supply: Public Water Well
Proposed Start Date l° 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-,;A' ` Gas a�'� the holder of Drain
Layer's License No. dZd e I� `�' . Only holders of P1 oo0Iicenses 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
Date: Id d�2
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
-- TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 0 --
BUILDING ADDRESS : '?a3
STREET : ze.�. �-✓a.••
SUBDIVISION: L F, S
NORTH ARROW
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CONTRACTOR (PRINT) NAME Or-CONTRACTOR'S SUPERVISOR PRINT
STREET ADDRESS SIGNATURE
C�V /6 t e 2-3 Q uit DATE
TOWN STATE ZIP INSPECTED BY TOWN
d_7 /, / ?3 t� DATE
TELEPHONE NUMBER !
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER