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HomeMy WebLinkAboutDrain Layers Permit 61 Eagle Run TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 7817 Con vat'tor WILCOX, 14J.CHAEL (EAGLE) sa. Location 0©61 $�jE;y,$ .� �Y2�i ,e ',' .>z';EAG SERV. Type Work NEW SAN LAT a �1 M�SUidA .N 1AD �3 CdT 0 619 F r PCop NP y� kA�6�9 2027s. r Date Insp Needed Ate;.,:. T ..;:..,.,. ime Insp Needed "` a" I Inspected By '15t. Work in Progress gff, .,uy, 9. 41 y >, : M. te i I i `Permit No. 7817 Town of South Windsor, CT j Permit Date 09/14/2004 Drain Layer Permit j Expiration Date 10/14/2004 INSTALL SANIT. LAT :O:; $ `" Descrip: •.�' Applicant :y'` � .� �.'^Gy SA?^k5S'%<, '�` Name WILCOX, MICHAEL (%EAIt � � �� K7TN c ANNARYdQ $(��LDERS INC Addr. EAGLE EARTHWORK,SERV 101 N MOUNTAIN g07147' sy 5 ' g CANTON QT .0�0 � > ;y Phone No. (860)693-202 Y "•9 � by the The Drain La er ssi rfe- s 8 y:.. :: 1 state and hereby age¢ ."to" 1"fhe £erm's aii cori"cT'i, ; i7r# 'st>a. or.:[h in the T '%" 'ret'an'n `:vz G'la 'on of South attached 'Conditions All°witci J.j Windsor standards, all.. OSMA` cjuirenF ' sG�l `1 ataC'hds:eoditions. i s QErw-- Issued By ,, p'. Zite — — -------- w'a.. ;a. Date Inspected --------------------- Insp6ec� BY _ _ ------- I i. i �78l� A 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: Lot # Street No. Street Name Premises owned by: Name of Finn 7 G) Phone: � Z0 Z Address-of Firm; d TYPE OF WORK: Lay House Drain Repair House Drain . - . 1-Dy Maln a Building . Lay Laterar for Commercial/Industrial awes Connection will be made with d , (f10 Existing Water Supply: Public.Water__ ___^ Well Proposed Start Date I-7— Estimated time for Complet!on ALL WORK-TO BE IN ACCORDANCE WITH*TOWN OF SOUTH WINDSOR STANDARDS, ALL OSHA REQUMEMENTS AND CONDITIONS ATTACHED TO THE PERMIT Permit-is to be Issued.to JI ` 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: / z Print.Naive:AL ad / ensed Drain Layer Date:" :Standard Forms\Permitt\APPLICATION TOR DRAIN LAYERS PERM1T.doe t• •t rr �!► ' � r'� rrr r i ► r rr WROAMITIM1111 An vim �i MENrrr rrrrrr �l�r r rrr� r ■ r rr rrr� ■E ., !��rr r rr ®r � r r► r r ■ rr � r rr r r��r rr r r rrrrr rrrr ■ ��r,� r ■ ■ ■rrrrrr r rr � .� •, r r rr ■ rr r ■ r �,-G � r rr rr�r_ arr� ■��rir� rrrrr rr�rr�irrrrr rr r�r �r►�rr r rrrrrr rr r �rLor�r r rrrrr t ;• tt t t• t. t t t t• t t t• . TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS STREET -�- SUBDIVISION: NORTH ARROW a L . to � 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