HomeMy WebLinkAboutDrain Layers Permit 27 Hitchcock Way i
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No . , 6555 Contractor MICHAEL WILCOX
Location 27 HITCHCOCK WAY Address EAGLE EARTHWORK. SERV .
Type Work NEW SAN LAT 101 N MOUNTAIN ROAD
CANTON CT 06019
Phone.;�No. (860 )693-2027
Date Insp Needed ,Date . Insp: 9
Time Insp Needed I Time Inspt,' ^_ je!!� f
Inspected By "'`�
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riork in Progress �. - -�. '' 'l,�'_ `<.� c - - - -
Input
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Permit No. 6555 Town of South Windsor , CT
Permit Date 01 /15/1.J97 Drain Layer Permit
Expiration Date- 02/14/1997
Descrip: NEW SANITARY LATERAL
Applicant Location
Name MICHAEL WILCOX Addr,. 21 HITCHCOCK WAY
Addr. EAGLE EARTHWORK SERV. r-nibi^ -,MAN,NAkINO BUILDERS
101 N MOUNTAIN ROAD
CANTON CT 06019
Phone No. (860)693-2027
The Drain Layer assigned this lermit has a 'Valid� license issued by the
state and hereby agrees' td. all the terme :,and conditions, set forth in the
attached 'Conditions ' . Al1 ,work shall , be ih accordance with Town of South
Windsor standards, all OSHA requirements, anu ,the attached conditions.
Issued By
Date InspectedL1�,�1 9 T�ispected By
/ / —.__—�
APPLICATION FOR DRAIN LAYERS`PER NHT
TOWN OP SOUTH WINpSOR
PtMVC WORKS DAP
AI TMEN_T
'OWN
1540 SULLIVAlkA
SUUTH,�VTNDSOR,,CT
FEE$25:00
Location of rroposed w#rk; I �,. Gh' Lot:#,
1—'
Street No. Street Name
Premises owned by: ,:7614 ', iUL�i'S.
Name Of F'ifitr Y1 n f. @�
Address Firma of
TYPE OF,WORK
Lay House Dr Reptir h?�4se Drain';
Lay 11 ain Lary L+ teral'for Cor►��iercia/Industrial
Building of acres-
Connectidn,usill tie made withII -� 5
Proposed Mart Date I:/b` Estirre,Qtted time for completion ! "
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ALL -WORK TO BE 1!i1T ACCORDANCE WITH TOWN Ol+' SOUTH u►'INDSOR
STANDARDS, ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO
THE PERMIT
Permit is to be.iss;ued `to /"[�r P �, { the holder of Drain
lager's License No. Z (_ Only holders of Pl, P7 8a W9 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.
c
Si ned: Print Name
9
Licensed Drain Layer
1
Date: