HomeMy WebLinkAboutDrain Layers Permit 802 Dzen Way TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7469 Contractor WILCOX CONSTRUCTION CO(DARRYL)
Location Address 535 OLD STAFFORD ROAD
Type Work NEW SAN LAT TOLLAND CT 06084 i
No. (860)871-1839
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Date Insp Needed
Time I nsp Needed 1 c) 9
Inspected By
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Perin#'t=' *o -- 7469 Town of South Windsor, CT
Permit Date 07/16/2002 Drain Layer Permit
ExpirPatfon Date 08/15/2002
Desc r i p�:"
Applicant �. Location
Name WILCOX CONSTRUCTION C 0 DZEN WAY
Addr. 535 OLD STAFFORD RO U AN TOWN HOMES
TOLLAND CT
Phone No. (860)871-1839 '
The Drain Layer a as cense issued by the
state and hereby agr e t nd i s set forth in the
attached 'Conditions' l a c with Town of South
Windsor standards, al t ached conditions.
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Issued By ^
Date Inspected By � o-�`
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: 4 ���7 �y loe>l Lot #
Street No. Street Name
Premises owned by:; � ��
Name of Firm: Gl//��y �oa� C Phone: �`l
Address of Firm:
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water Well
Proposed Start Date,Z��stimated time for completion CZ
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 Ielgwll I the holder of Drain
Layer's License No. . Only holders of P1 or P7 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:
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
Y TOWN OF SOUTH WINDSOR
SANITARY - SEWER LATERAL `FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS ToL
STREET
SUBDIVISION:
NORTH ARROW
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CON RAT CTOR�(PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER