HomeMy WebLinkAboutDrain Layers Permit 28 Eagle Run (2) TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No 7971 Cont-va'ctor WILCO-;""MZCHAEL (EAGLE)
Location r F;AG7a RUN ,:Addre��l.;. EAGI;8, E?Y'RTHV7ORIC SERV.
Type Work NEW SAN LAT :3;::;9,.46UTdAN "12OAD
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Permit No. 7971 Town of South Windsor, CT
Permit Date 09/27/2005 Drain Layer Permit
Expiration Date 10/27/2005is
Descri INSTALL SANIT. SEW. ,1 :E L
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Applicant Loc`&.t£on
Name WILCOX, MICHAEL (.EAGLE') Adder D:€14 BAGLE RUi7
Addr. EAGLE EARTHWORK -t3ERVQwnex- �IANNAR7NO $UILDERS INC. I'
101 N MOUNTAIN ROAZ
CANTON C-T:;OQ019
Phone No. (860)693-20.2T
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The Drain Layer assigned- tsi�t313eense zssued by the
state and hereby agr:ze's"to::'a ;l'< he terms and con'd'is3'i #<'s;et>::::_forth in the
attached 'Conditions' . All wd k sh "7.` :r` # 9 orda Ce with ToWn of South
Windsor standards, a ,taTi@d:.eotditions.
IssuedBy -------------------------_<, :... --- -------------------
Date Inspected Irisp'ected By _
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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 work: /.
proposed � {`��✓' Lot # rc7
Street No. Street Name
Premises owned by:_ G�i
Name of Firm: Phone:
Address.of Firm: U
TYPE OF WORK:
Lay House Drain2_; 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 _ , C'� e
Po 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 the holder of Drain
Layer's License No. .Z 7 jj (0 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:
�1.
g Print Name:
A. i!cinsed LDra/inayer
Date:
Standard forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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