HomeMy WebLinkAboutDrain Layers Permit 5 Hunter Drive . a TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit °No. 6803 Contractor WILCOX CONSTRUCTION CO(DARRYL )
Location 5 HUNTER DRIVE Address 535 OLD
L STAFFORD ROAD
Type Work NEW SAN LAT TOLLAND CT 06084
Phone "Np. (860)871-1839
Date I nsp Needed "Insp
Time Insp Needed _ / !"' Time nsp;
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Inspected By
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Work in Progress
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In-Out 12 L(_' _ Date
'ermit -No. 6803 Town of South Windsor , CT
'ermit Date 05/13/1998 Drain Layer Permit
::xpiration Date 06/12/1998
)escrip: PRORATE #6
Applicant Location
lame WILCOX CONSTRUCTION CO(DARRYL} Addra 5, HUNTER DRIVE
�ddr. 535 OLD STAFFORD ROAD a rB, & M, ENTERPRISES
TOLLAND CT 06,6
'hone No. (860)871-1839
The Drain Layer assigned .th ,'s permit has a vailid license issued by the
state and hereby agrees to;;ai1 the terms and coed t-ons set forth in the
attached 'Conditions ' . -Ai � W0.r=k sha 11 ,be fin acc€ r;d" with Town of South
Windsor standards , all'., OSHA:,requ�irements�z an, tbe' attached conditions.
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s s u e d By
Inspected By gate Inspected ----- _4 °
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: �s;: �� P� ►��- lOga�
BUILDING ADDRESS : 5 4fAaAAtA, ov alP.
STREET : s
SUBDIVISION.
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATU
A/ �ji �f 90 DATE
TOWN STATE ZIP INSPECTED BY TOWN
S DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PROJECT: . / S s i r DEVELOPER:
STREET: CONTRACTOR:
DATE: g ME: D�
WEATHER: Q S INSP: 7/ 1
WORK IN PROGRESS:
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AREA OF CONCERN:
SPECIAL INSTRUCTIONS:
APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work/�c�� `�� /�/� �� Lot #
Street No. Street Name
Premises owned by:
Name of Firm; /` c/- Phone: 6'G
Address of
TYPE OF WORK.
Lay House Drain � Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Proposed Start Dates�� T'OEstimated 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 the holder of Drain
layer's License No.e,-v.2or�r�% ,� Only holders of P18a 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.
Signed:
Print Name��Z��i�, •l�/�� y
Licensed Drain Layer
Date: c�/