HomeMy WebLinkAboutDrain Layers Permit 21 Hunter Drive TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 6712 Contractor WILCOX CONSTRUCTION CO
Location 21 HUNTER DR Address 535 OLD STAFFORD ROAD
Type Work NEW SAN LAT _ TOLLAND CT 06084
Ph.one..:kNo. (860)871-1839
Date Insp Needed
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Permit No. 6712 Town of South Windsor , CT
Permit Date 10/23/1997 Drain Layer Permit
Expiratidn Date 11/22/1997
Descrip: CK 2249 4 LOTS
Applicant Location
Name WILCOX CONSTRUCTION CO Add ,1. 21� HUNTER DR
Addr.. 535 OLD STAFFORD ROAD ` fiwner` &MINT.
TOLLAND CT OGf �
Phone No. (860)871-1839
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The Drain Layer ass [ ttM pem � � t i cense issued by the
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state and hereby agres t i ther� tind �tar set forth in the
attached 'Conditions' A1T ! ? sh � n acc��r �e with Town of South
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Windsorstandards, al � rnd i`� ched conditions.
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Date Inspected Ia� ��7 �
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TOWN OF SOUTH WINDSOR
5ANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS ►
STREET
-I- SUBDIVISION:
NORTH ARROW
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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
APPLICATION FOR DRAIN LAYERS PERMIT y8 0
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work: l / if,^' �' eZi `'mil Lot #
Street No. Street Name
Premises owned by:
Name of Firm: d {1T- z% c Phone: P,�-1
Address of Firm:C5-713--y- of'I/
TYPE OF WORK:
Lay House Drain_ Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres _
Connection will be made with
Prop osed Start Date mated time for completion ,-'V
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 �/J`¢f� ��' , G�����y S the holder of Drain
layer's License No. 0a 0 �r3 9 Z." Only holders of P , 1 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.
Print Nam f
Signed: �' �
Licensed Drain Layer
Date: