HomeMy WebLinkAboutDrain Layers Permit 49 Eagle Run * TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7889 Gp--nV;raGtpiz WILic, 'MI.CHAEL (EAGLE)
Location 0049 EAGLE RUN s} !7 ``fEAG *ARW:HW`0RK SERV.
Type Work NEW SAN LAT kV TAIN 'ROAD
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Permit No. 7889 .,.« Town of South Windsor, CT
Permit Date 03/21/2005 z ,,. Drain Layer Permit
Expiration Date 04/20/2005
Descrip: INSTALL HOUSE LAT4.kAL,,;
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ApplicantJ.on
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Name WILCOX, MICHAEL' .3.r. �b49--<:T�TE`::;RUAI>
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Addr. EAGLE EARTHWORK SERV f�ta�t aAlANNARING B TILDER INC
101 N MOUNTAIN.;R€DAD
CANTON
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Phone No. 860 693-2<02 y: >' °F, K;:: :::a•,::
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The Drain La er i.ass'i : ;<id><?� ..': sis " `s rued b the
state and herebya `ree t:`< '..<:'
g e�,. � l the e,� � �; ,�. a"Gu��ns seC :;Earth in the
attached 'Conditions:'f All`<,. io Ic:.. " " 4� da'ri ' .<`w'th Town f
Y3d 'r'F< :., : '„'..'- :> o South
Windsor standards, al-- 0.AA etui) tti t ; �€ 'kk}e a aches conditions.
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Date Inspected _____________________ Inspected 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 proposed work:. a Lot # �7
Street No. Street Name
Premises owned by: 11Q,q Z rid` y
Name of Firm: ( Phone: -.70Z--/
Address.of Firm:_/o(
TYPE OF WORK:
Lay House Drain ; Repair House Drain
La Main '
Y ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with ��
Existing Water Supply: Public Water_ Well
Proposed Start Date "Z 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
h Permit is to be issued to _ �G 2L� ( ft1 � the holder of Drain
Layer's License No. R-7el e(4, 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:
Licensed Drain Layer
Date: (._0 5
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: �vevE l� 2°Oy
BUILDING ADDRESS M.
STREET E-7 A CoLE f�,JN
-E- SUBDIVISION:
NORTH ARROW -
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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
WHITE - TOWN PINK - CONTRACTOR YELLOW CONSULTING ENGINEER / DEVELOPER