HomeMy WebLinkAboutDrain Layers Permit 84 Eagle Run TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7815 Contr.aa;tb!rt7.II OX,p;+..ICHAEL (EAGLE)
Location D`0$ 994 ,dire ;;a YEAGL` `EX4TIY'WQ.,RK SERV.
Type Work NEW SAN LAT
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Permit No. 7815 «,..•...•..• Town of South Windsor, CT
Permit Date 09/14/2004 "s^' Drain Layer Permit
Expiration Date 10/14/2004
Descrip: INSTALL SANIT. LAT.
Applicant eLf3:C < n
[ at
Name WILCOX, MICHAEL (' fiG7yE) �0 $ AGLF RUri# t';
Addr. EAGLE EARTHWORK :SERV .: NNAR7O BYULDERS"'.,INC
101 N MOUNTAIN OAD,' Y
CANTON CT 0$03
a'r,:<
Phone No. 860 693 2Q'2'7� �..
The Drain Layer ssit rief'` s k s,„ Ana:e '?'"s'` ed b the
state and hereby agr'e 's,_t: dY" ''•I> k�e to and ,pnd':trx'o "'s: t, o h in the
#steal "+ oYs.ax�o�.::.wnG`h TokVn of South
attached 'Conditions
All wc3 �:
Windsor standards, alb"OSAaq iray'. sc� , i0.
c>•. a 'hedoYiditions.
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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: t
Lot# AL
Street No. Street Name
Premises owned by:
Name of firm: �� i 1A A .Phone:-
Address.of Firm:
TYPE OF WORK:
Lay House Drain Repair House Drain
- lay Main"-----; .
Lay Laterar for Commercial/Industrial
Building of acres
Connection will be made with_ A .Oi//,7
Exing Water Supply: Public Water Well
Proposed Start Date/( Estimated time for omp Teti t�
on
All WORK-TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUT1184ENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is.tq-be Issued.to the holder of Drain .
Layer's la6ense No. 7 7 t Ito 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: 6�49-( 64)
Licensed rain Layer -
Date;
Standard Fotms\Perin ts\APPL.1CAII0N FOR DRAIN LAYERS PERMrr.doc
TOWN OF SOUTH AINDSOR
SANITARY - SEWER LATERAL FIELD , LOCATION
DATE OF CONSTRUCTION: 2 Ll
BUILDING ADDRESS : �l
STREET
SUBDIVISION: Z4 "le Rut )
NORTH ARROW
XT
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CO TO (PRINT)) NAME C CTOR' S SOR (PRINT)
STREET ADDRESS SIG RE
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��GJa DATE
T
TOWN STATE ZIP INSPECTED BY TOWN
3 -2CJ� DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
TOWN OF SOUTH ANDSOR
SANITARY SEWER LATERAL 'FIELD LOCATION
DATE OF CONSTRUCTION: 2c)D
BUILDING ADDRESS : L�
STREET . E -RG' L-E Roo
-E- SUBDIVISION:
NORTH ARROW
(„
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 f DEVELOPER