HomeMy WebLinkAboutDrain Layers Permit 70 Eagle Run e a '
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7874 Con t.ra>c'tVk;`T7TL'COX..,:;..:.MICHAEL (EAGLE)
Location 0070 EAGLE RUN ,:A- dress '':i EAGLE ::E.BdNWORK SERV.
Type Work NEW SAN LAT 101 N MOUNTAI11%.ROAD
AST 014 ,CT 05.019 >:
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Date Insp Needed /o,
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Time Insp Needed — Tim "U"; 7�
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Permit No. 7874 Town of South Windsor, CT
Permit Date 01/13/2005 Drain Layer Permit
Expiration Date 02/12/2005
Descrip: LOT 9
Applicant ca't ion
Name WILCOX, MICHAEL ($AGL$):.. Acdr 00'7 EAGLE RUAT e
:
Addr. EAGLE EARTHWORK"SERV.;> MANNP'kINO.;°BUI'LDAS INC
101 N MOUNTAIN:`ROAD
CANTON GT 06019:
Phone No. (860)693-20^k7 y i -
5
The Drain Layer aesgned this � a sgued by the
f
state and hereby agreeiX toy�l the �riincCfirYdit34h :Set.. faith in the
attached 'Condition ' ; 7�11 w srk h k9 { cevxdancc �e�th T. wn of South
Windsor standards, a-1 OSHA 3Z6qd1rejW t s, A.......... the att' ch�d.:'ccsnditions.
Issued By
Date Inspected Trispeet'e'iBy
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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: 70 &4L 44 Lot #
Street No. / SiOet Name
a/`
Premises owned by: K <l &/ .
Name of Firm: f 4f' Phone:
Address of Firm: 10( df`t 0 v 0/ta t
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 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 toabe issued to _ cC�C�'� ��D the holder of Drain
Layer's License No. 7-78 11 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: i�� I'
Licensed Drain Layer
Date:_ /—1
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:
BUILDING ADDRESS L
STREET
-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