HomeMy WebLinkAboutDrain Layers Permit 44 Eagle Run (2) TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7953 Contxaor WILCd "`>_M:ICHAEL
Location 0044 EAGLE RUN (EAGLE)
Tx'3dres <..EAGLE:Type Work NEW SAN LAT "` EARTHWG.RK SERV.
M6UNTAI,N ''R,OAD
TITpN°UT..06U..19
Phone .iVa (8�r0. �,�'3 -202,7
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Date Insp Needed
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Time Insp Needed -____-_-____
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Inspected By �ti . -
Work in Progress
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Permit No. 7953 Town of South Windsor, CT
Permit Date 08/08/2005 Drain Layer Permit
Expiration Date 09/07/2005
Descrip: SEE PMT 7937 EXPIRED>^` -
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Applicant
Lat' on
Name WILCOX, MICHAEL
Addr. EAGLE EARTHWORK :SERV 75ER3, INC
101 N MOUNTAIN ROAp:.
CANTON CT `06019
Phone No. (860)693-2427
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The Drain Layer ass� ns$ this'„ z� his va �d ]igns�e ASjs4-ed by the
state and hereby agrees tp;<:a 1>;;the'�C Tw a'n'd' ceiYtt i't,'<t.:""?: set;;`for.: h in the I'
attached 'Conditions .A11 wo. Yc 5ha `1 :. .yam .... dan 'e witki Town of South
Windsor standards, all OSHA requiY.. .... and the at
t hed conditions.
Issued B ----------------
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Date Inspected ...'"" •"'
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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: 4A E . Lot # _
Street No. Street Name'
Premises owned by: � T p � n
Name of Firrn: e'►` !-t) ,E' Phone: 6 f. W Z-,7.
Address.of Firm: IwA. �
TYPE OF WORK:
Lay House Drain_; Repair House Drain
Lay Main Lay Lateral-for Commercial/Industrial
Building of acres
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Connection will be made with lote-
Existing Water Supply: Public Water_ Well
Proposed Start Date U : 9 Estimated time for completion c'
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 M Il o �,�� 4 the holder of Drain
Layer's License No. -Lz 811L Only holders of P-11 P-7 or W-9 licenses
will be issued a permit. PERMIT WILL EXPIRE THIRTY(30)ZAYS 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: ` f ;
-- Print Name: /`��� u C t
Licensed Drain Layer
Date:
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY - SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET
SUBDIVISION:
NORTH ARROW
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CONTRACT PRINT) / NAME OF CONTRACTORS SUPE SOR-(PRINT)
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STREET ADDLR,ES-SS I q SIMAURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
9 ro ^ �� � DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER