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HomeMy WebLinkAboutDrain Layers Permit 20 Eagle Run c Q TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 7879 Con.Gra'C't'or WIL -ox :::.:;MICHAEL (EAGLE) Location 0020 EAGLE RUN Address EAdi;.8 BARTRWQRK SERV. Type Work NEW SAN LAT 1,01N MOUNTAIN ::ROAD ,ANT64 'QT 0t.019 Pfaone No { 6Q)693 2©:27 Date Insp Needed _--- Dat�e Ih p � Time Insp Needed ------------ -- dime T �3' t►i Inspected By Work in Progress _S—C/YD`ri-i6Ts�kCG t0 � rye-avw".� �/ sj --/ .. j. 1 7� Permit No. 7879 Town of South Windsor, CT Permit Date 02/14/2005 Drain Layer Permit Expiration Date 03/16/2005 { Descrip: { Applicant hoeah::ion ' Name WILCOX, MICHAEL (MPbLE3 ?�ddr A020 EACL$ ItTm .>. $ Addr. EAGLE EARTHWORK V SER Citiaier MANNARINQ BITI3bERS INC S, 101 N MOUNTAIN i2O3p.. ! CANTON GI 0.6019 Phone No. (860)693-2027.. ` The Drain Layer assglae this peritsat liar a3id j.x' cense. issued by the state and hereby agree > tq: 1 the terms =and tcrhdits�xxs set::. forth in the attached 'Conditions' . 'dill work Y 'll be as ecrrd�xkce with Tow of South Windsor standards, al.l OS$A requir i nts : azid -tie att Ched ::cgnditions. Issued By ------------- Date Inspected ---- `Ins e:cted B — — ------------ -- p Y APPLICATION FOR DRAIN LAYER PERMIT 'j TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $60.00 Location of proposed work: 2 lFa Iq_ 12 Lot # j Street No. JJ Street Name Premises owned by: Manodt a!r(�EUS Name of Firm: Phone: 6 —Z047,7 Address of Firm: & TYPE OF WORK: Lay House Drain Repair Repair House Drain ; Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with � (16 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 /-'G44�� C66 the holder of Drain Layer's License No. Z7 J& 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. Signed:ZA'w Print Name: �eU�z Licensed Drain Layer Date: Z — Y"0 Standard Forms\Permits\APPLICAIION FOR DRAIN LAYERS PERMrr.doc Ito - - t ' i' ITT MEIN NINE M /1'�i I � 1`)"! ■�r�� �� ■INN , ■ �� MMOR ON I r MEN ''sue►-�. �1 ri�_- i TOWN OF SOUTH ANDSOR SANITA RY SEWER LATERAL 'FIELD LOCATION DATE OF CONSTRUCTION: 2PPLA BUILDING ADDRESS STREET Q.st" -F- SUBDIVISION: NORTH ARROW j0000 � E ✓ CONTRACTOR (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