HomeMy WebLinkAboutDrain Layers Permit 25 Hunter Drive TOWN OF SOUTH WINDSOR INSPECTION REPORT
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P,erin'ifet ~!`o. 6714 Contractor WILCOX CONSTRUCTION CO
Locat-on 25 HUNTER DR Address 535 OLD STAFFORD ROAM
fyp6iWork NEW SAN LAT TOLLAND CT 06084
Phone No. ( 86U )87 1 -- 1839
Date Insp Needed
Time Insp Needed _ i:me Trip -- �--
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Inspected By
Work in Progress
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Input — - — Date --_ — -- -
Permit No. 6714 Town of South Windsor, CT
Permit Date 10/213/1997 Drain Layer Permit
Expiration Date 11/22/1997
Descrip: CK 2249 4 LOTS
Applicant Location
Name WILCOX CONSTRUCTION CO Addr. ` 25 HUNTER DR
Addr. 535 OLD STAFFORD ROAD Owner 8&M ,ENT •
TOLLAND CT 06084
Phone No. (860 )871 -1839
The Drain Layer assigned thi,4 permit has v441fd Iicense issued by the
state and hereby agrees terms and`'c'" icr� set forth in the
attached 'Conditions ' ,,, AI i� �-Wor,R sha11 ate ,in abrdance with Town of South
Windsor standards, all OSHA. requi,roments,, . -and the attached conditions.
Issued By -
- -
Date Inspected ins�aected` By -•--- f_-
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET : mow ov'Lue-,
+ SUBDIVISION: PLC► -c C '.�►�.c�
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
TOWN OF SOUTH WINDSOR 6 7i y
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work: % v7i e Lam':_ Lot #
Street No. Street Name
Premises owned by:
Name of Firm: _•:, IZ% Phone: %?
Address of Firm: J � t-✓ �'�l /— -v� �-✓ �� Tc7/�i c:� —�/�
TYPE OF WORK:
Lay House Drain Cam' ; Repair House Drain ;
Lay Main ; Lay Lateral for CommerciaVIndus trial
Building of acres -
1✓
Connection will be made with
Proposed Start Date o >'� mated time for completion 6,
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 tq��'.' ��f7 /� ,�= L�/ '`�'f �' the holder of Drain
layer's License No. G-� �v �' Only holders of P1,,07,)& 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%��%���``_/�
Licensed Drain Layer
Date: G