HomeMy WebLinkAboutDrain Layers Permit 4 Eagle Run E
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7857 WILCO'Con�.,��'�'tor WILCOX'° �HAEL (EAGLE)
Location 0004 EAGLE RUN --AddXeS*' '�4EAGLS—.-.ARTH'6RK SERV.
Type Work NEW SAN LAT '
AdUN' AIN"''AfJAD
Da
te In
e.
s
P
Nee
ded
ed
D•� t
sAL `i
Time Insp Needed ———————————
'FAA k
Inspected By .., %•.x r;: ,,,. ;u'":o, ::F';:y. .
A. k
Work in Progress
- °-- ------- Ala:
- - -
d Input£ y.,..",. w... Date
Permit No. 7857 Town of South Windsor, CT
Permit Date 11/08/2004
Drain Layer Permit E
Expiration Date 12/08/2004 kE` y
Descrip: LAY HOUSE DRAIN
ApplicantF Lc7a.t<tion
:
" <` }`
c �..
Name WILCOX, MICHAEL '{
S?�JQ�,:%,AGLE M.
Addr. EAGLE EARTHWORK ;SERV. e` O' r MANNARI'Q:`,&L:IbEREk. INC
101 N MOUNTAIN
CANTON /v:yx :0E0. .
Phone No. 860
The Drain Layer assLgg.eai:; s' h. s'<- `
., #' `; n. .` .,a 1 :' rii ; .slued by the s
state and hereby agree.. to``': <%' �` x"
Y 5 . �k.`3`- e errts' �nci cd 3'di a 4ri ; : ; t';'.for; h in the
attached 'ConditionsY+ :%� ;'�1Y1';;avt2k, '. of South
Windsor standards,
alb. OSIA`'' uixn t e at `<iie
a x• '# ..•. G ' t3,„�°o.k1ditions.
l to %
Issued B
-------------
:
Date Inspected Ins
p ---------------------------
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: ` Lot #
Street No. V Street Name
Premises owned by: hA czv�14a
Name of Firm: fj�&Je_ p,''"h w0�4 f�. Phone: zD
653 z7
Address of Firm: /))/ A)o A 0MItb'_1i )U_-
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
Existing Water Supply: Public Water Well
Proposed Start Date 1'`/ 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 (��� tl 1,t/u C GUK the holder of Drain
Layer's License No. 27 9 11 to Only holders of P-1, P-7 or W-9 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.
I-RSigned: W— Print Name: M t t_6l,q et 0,160,,4
Licensed Drain Layer
Date:_
StAfidard'Forrns\Permits�APPUCATION-WR-.DRAINLAYERS PERMIT.doc. .
Alai
MIN
ISO
■HOW,
No EVA Ml No
MEN �If �0 ■ ' .�2 Igo ■SIX
j r IMCI
1 M C j/ , L' ...►i1/
< -
-Ra !
TOWN OF SOUTH WINDSOR
SANITARY - SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS z c 7 -Z
T J2 � ►S REET
SUBDIVISION:
NORTH ARROW
.`
CONTRACTOR (PRINT) E OF CONTRACTOR'S SUP SOR (PRINT)
STREET ADDRESS++— SIGNATURE
6It (l Ct O ��.5� /— a � DATE
TOWN \ /STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE — TOWN PINK - CONTRACTOR YELLOW — CONSULTING ENGINEER `/ DEVELOPER