HomeMy WebLinkAboutDrain Layers Permit 52 Eagle Run TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7871 Contra
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Location 1,rdr`es ,EAG• EAR1"KWORK SERV.
Type Work NEW SAN LAT } '3';O1�T IQUTAIiF<::;,ROAD
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t Permit No. 7871 Town of South Windsor, CT
Permit Date 12/07/2004 ^`°" '"" '-< Drain Layer Permit
Expiration Date 01/06/2005
Descrip: `
Applicant s f Y LOon
Name WILCOX, MICHAEL ( P I4E} Y 00 AG"
Addr. EAGLE EARTHWORK RSERV' sbr MANNARO BiJI 'ISER$ INC
101 N MOUNTAIN2
CANTON
Phone No. (860)693-262�7::.<� ><`.�iz:% ��>,<4`.<:ar : (
The Drain La er?as'`' w1 #is ? At?8 > ''d ticeri` ea::.` .stied by the 4
state and hereby ageq <to as< theer atfdc�#Yt�aorr{: forth in the
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attached 'Conditions:;' r>> 11::;raarltf' €�I` -` i<=: : 'J? a -C,-;6 with 'Town of South g
Windsor standards, ail OSUA onditions. !
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«Issued By "`><,." ..:: ,'' . »T. : . ': # '---�F` --------
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Date Inspected `'ir�} crieci Yy _ _����
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: #
Street No. Street Name
Premises owned by: A4 � z,i`h� 5
Name of Firm: ur Phone: ZOz�
Address of Firm: D f rV r�}—�
TYPE OF WORK:
Lay House Drain_; 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.T 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 4 `_ Pil' 6 h 1 NnY the holder of Drain
Layer's License No. Z_:opt(.& . 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:
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TOWN - OF SOUTH WINDSOR
SANITARY SEWER LATERAL 'FIELD LOCATION
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DATE� OF CONSTRUCTION: 2004
BUILDING ADDRESS Lo i-
STREET
-f-- 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