HomeMy WebLinkAboutDrain Layers Permit 12 Hunter Drive TOWN OF SOUTH WINDSOR INSPECTION REPORT
'ermit No. 6738 Contractor WILCOX CONSTRUCTION CO
.ocation 12 HUNTER DRIVE Address 535 OLD STAFFORD ROAD
'ype Work NEW SAN LAT TOLLAND CT 06084
Rhone' No. (860 )871-1839
late Insp Needed Date In,
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Inpu Date
Permit .,No. t 138 Fawn or South Windsor, CT
Permit Dat.e 1 2/ 1 �/ 1 997 Llrs 1 n Layer Permit
Expiration Date 01 /11 / 1998
Des c`r1P :
Applicant Locat i or)
Name WILCOX (;ONSTRUCTIOiN CC) Addr . ; 12 _HUNTER DRIVE
Addr. 535 OLD STAFFORD ROAD caner 'F3&M ENT.
TOLLAND C T OW—4
Phone No . (860 )' 871 -1839
The brain Layer assigned ;this permit has k vaiid ! ic�ense i ssued by the
state and hereby agrees t a1 -1 the terns .andgn fcd"i,vidns set forth in the
attached 'Conditions ' '., A 11, w.o,ek sha I 1 be ,'yin arCor'.fiance' with Town of South
Windsor standards , a 1 t, 08HA.;rsclul,rernen and trte', attached conditions.
Issued By - .rr, I =
)ate Inspected y Ins ected J
B.Y
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET : 4 o'er '
SUBDIVISION: -
NORTH ARROW
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CONTRACTOR (PRINT) DAME—o --ewN ACTOR'S SU E IS (PRINT —
STREET ADDRESS y IGNATURE
�l DATE
TOWN STATE ZIP INSPECTE BY—TOWN
D
DATE
TELEPHONE NUMBER
WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER
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 worzz 1, Al�,�� /d al Lot # �S�
Street No. Street Name
Premises owned by:
Name of Firm: ��L �r �.� ��� <<�` C� �,1 Phone: > �-�
Address of Firm:1 SrJ�^ ,::Q,/. .-/ -5 'I`lY/= ���� ,l2 c✓ 7%` � ✓ �''�-��G�
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 Date ' /' 1?stfmated 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 the holder of Drain
layer's License No. 6 CZ 24—�, Only holders of P1, P7 & 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::= --)
Signed: G� Print
Licensed Drain Layer
Date: / zL/y >P-,