HomeMy WebLinkAboutDrain Layers Permit 83 Eagle Run i
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7820 C
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Location ` EAGLE)
A T S WK SERV.
Type Work NEW SAN LAT :A "
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P4'o}ie 40211i
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Permit No. 7820 Town of South Windsor, CT
Permit Date 09/14/2004 i<>i" i ,,k,. Drain Layer Permit
Expiration Date 10/14/2004
Descrip: INSTALL SANIT. LAT.. «. :..
N.
Applicant Lqc:a z9n
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Name WILCOX, MICHAEL ( Af z<x'<sCf7x 018 Fx. �?
Addr.. EAGLE EARTHWORK ::DERV. :;, lv?? I4ANNAI;, AIOr B:GS LDERS< INC
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101 N MOUNTAIN0 ,% 'z?�f�^ 3 ' `
CANTON :x::,OEV`0. "9. `».^<."Is '< .. >.% t ..
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860 693-20`2'�"
Phone No )
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The Drain Layer ��s'signedi';,� t�s s Y
ar< .�a3di<i.:y
state and hereby agir- $a; 2`"Y'ire terms and cori `bn£''eetai;:: .grh in the
attached 'Conditions s "All o'fF sal i;.} o.r.. ax: ,;w3tin ToLn of South
:;s:;i< :iTe. at.: a, h .d; oditions.
Windsor standards, a11. uir: tnC. ;yi
Issued By ----- _\ -- ii — -----------------
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Date Inspected --------------------- Inspected By _ ---- -----
4- 8
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#—LL .
Street No. Street me
Premises owned by: J
Name of firm: 9 � �r.� v\ Phone: p3-Z47�7
Address:of firm: Id d�
TYPE OF WORK:
Lay House Drain_; Repair House Drain
Lay Main"------; Lay Laterar for Commerdai/Industrial
[iuilding .of acres
Connection will be made with
F—Asting Water Supply Public Water Well
Proposed Start Date L. Estimated time for Completion
ALL WORK-TO BE IN ACCORDANCE WITH,TOWN OF SOUTH WINDSOR STANDARDS,
ALI,OSHA REQUIREMENTS AND CONDITIONS ATTACKED TO THE PERMIT
Permit-is to be Issued.to .
Layer's License No. /�� the holder of Drain .
will be issued a Only holders of P-1; P-7 or W.9 licenses
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:A __4 ` Ia Naive• L 0 "G2 zz
q Ukens Drain Layer
Date: /, �/`Z`•'�
Standard Forms\Permit5\APPLICAIION FOR DRAIN LAYERS PERMIT doe
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TOWN OF SOUTH ANDSOR
SANITARY SEWER LATERAL 'FIELD LOCATION
DATE OF CONSTRUCTION: `2-0 0
BUILDING ADDRESS : L 1 Z
STREET F,A(6t"-V- vN
-E- SUBDIVISION:
NORTH ARROW
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466
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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