HomeMy WebLinkAboutDrain Layers Permit 41 Eagle Run TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7939 � 'tra.tg WII40UX,�vn'OHAEL (EAGLE)
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Permit No. 7939 Town of South Windsor, CT
Permit Date 06/24/2005 °" "ej<'ty,
Drain Layer Permit
Expiration Date ; v 07/24/2005
Descrip: LOT 18 ^�
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Name WILCOX, AE < €�MI CH L.
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Addr. EAGLE EARTHWORK>^SERV.�"�.;,:.:....;".. ' '
y r wr.wt1ANNAFEINO $1JILDER`"{w INC
101 N MOUNTAIN ROAD n>
CANTON GT 06�19 € 3
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Phone No. (860)693-207
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state and hereby " es;•<:«a^.^ _..:y ed by the
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attached Conditional `Al wt3 Ftsk3a j ', s'<. ""';gip: d
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Windsor standards, aid OS?HA'`,,p uir.:.•.£: "`'"""`k>k "
3X# =. 1ke aGa`che'i:z>cenditions.
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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: /so, Lot #
Street No. Street Name
Premises owned by:_ a
Name of Firm:_..(e l .�� Phone: 3- za Z-7
Address.of Firm:--(Q1 A214 t &M61M4 PN z
TYPE OF WORK:
Lay House Drain__; Repair House Drain ;
Lay Main ; Lay Lateral-for Commercial/Industrial
Building of acres
Connection will be made with PV/-
Existing Water Supply: Public Water, K 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 �iX LPL W,'l C ok the holder of Drain
Layer's License No. 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:- Print Name:. .nd 6Q
*1censed Drain Layer
Date:_ 2, —O
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Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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DATE OF CONSTRUCTION: 2-
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
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