HomeMy WebLinkAboutDrain Layers Permit 78 Eagle Run TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7855 Co 'ctor-WILCQX ""M CHAEL (EAGLE)
Location 0078 EAGLE RUNd '`
ds ;, EAGIaE FI�THWORIC SERV.
Type Work NEW SAN LAT } IZ M&U11--VAIN tOAD
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Date Insp Needed W/I' .DaYf
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Time Insp Needed $,T�.me; I . �01,
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Permit No. 7855 Town of South Windsor, CT
Permit Date 11/08/2004 ""' Drain Layer Permit
Expiration Date 12/08/2004
Descrip: LAY HOUSE DRAIN mil~
l i s` ry A,
App cant . ,',%< LQPt. .on
Name WILCOX, MICHAEL (33,AG4j �.hz's.: c6d� 1k7$ 1GLE2fi7h� `
- -:
Addr. EAGLE EARTHWORK >SERV. .' '.;. , QciyANNAgdO $7J4ILDER INC
101 N MOUNTAINO $S
CANTON
Phone No. (860)693-20i2*.." :i,::f»..' �...`:,�s^<°v,. :�.<ry:
The Drain Layer Srsi` nos' s!" } n e°1ss "ed b the
state and hereby agr',eds J.:0"t � .h�e` termp and conk'; : 'an ''`s.:e or: h in the
attached 'Conditions All`aac YZ:s i' `?.; or. an :;vsit'h Tcwn of South
Windsor standards, alb 0S14A"i ire , ? h� at ache ,,.coAditions.
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Issued By `' 't��/� __ .;. ''. _` ,g:;.:., . " / � ----------------
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Date Inspected .......... Inspect>ed By __
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: /' Ig 00v Lot # l
Street No. Street Name
Premises owned by: / amnamo . L i 4,5..
Name of Firm: o_lam )ve t (41&Wf Phone: 3'ZvZ7
Address of Firm:—/O/ /Uof�4 40 Afa- o`zt 126t 04yq
TYPE OF WORK:
Lay.House Drain ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with6 t(
Existing Water Supply: Public Water `� Well
Proposed Start Date/�/b 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 /41V64 the holder of Drain
Layer's License No. z 70116 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: (�t/ �"
9 Print Name: ✓y c �l�� W ileOS/_
Licensed Drain Layer
. �. ..... .Date:
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS : co to
STREET
-I- SUBDIVISION:
NORTH ARROW
M 1 3 �
Ad
i
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