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HomeMy WebLinkAboutDrain Layers Permit 83 Joseph Lane • TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 7975 »_>:.>...... Location 0083 JOSEPH LANE Cont :ad't'or WILCO ,CHAEL (EAGLE) Rddr.es3:== "`i;EAGL:E':EAFiTHWbR.K SERV. Type Work NEW SAN LAT 1 1- AI 146UN."kiAI RQAD ..... LI ON `CT 060.1.9 Date Insp Needed i -----------------= Date Trt9p Time Ins «..,. p Needed ----F-------- Time Iri ' Inspected By --- — . Work in Progress AuLz ( �f LZ 130� /is— Date Permit No. 7975 rr Permit Date 10/03/2005 Town of South Windsor, CT Expiration Date 11/02/2005 Drain Layer Permit Descrip: Applicant Location Name WILCOX, MICHAEL Addr. •EAGLE EARTHWORK SRU " 0083 J© F�PH i�1j _WSJ �IANNIEINCS`$U�LLlE2vS INC 101 N MOUNTAIN RpAD CANTON C1 Q6Q19 Phone No. (860)693-20Ri The Drain Layer assxgn. d this permit state and hereby a tees to all t has `� valid lT. eeflse issued by the Y g.. het4 and ci attached 'Conditions' datioi3s ?,set forth in the 1 wsr shah be 2n adne =with Towy of South Windsor standards, a11 .DSH t rzirtze #P:.: nd t attakitidid;itions. Issued By ` i -------------- Date Inspected ------------- d.<;SY APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $60.00 Location of proposed work: 5J is z . J44vi2 41-1 Lot # Street No. Street Name Premises owned UY.- Name of Firm: . '' Phone: � 2_;7 Address.of Firm: TYPE OF WORK: Lay House Drain J,,__'; Repair House Drain Lay Main ; Lay Lateral-for Commercial/Industrial Building of acres Connection will be made with Existing Water Supply: Public Water Well Proposed Start Date ` 3 Estimated 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 1_ ,( f ;� 4 the holder of Drain Layer's License No. 2-79f1h Only holders of P-1, P-7 or W-9 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. CBYD No. :Signed.a.Z_4�4_ Print Na r: me: � lC �l � 6icensed Drain Layer_ -`— Date:_ Standard forms\Permits\APPLICKTTON FOR DRAIN LAYERS PERMrr.doc TOWN 1F - SOUTH ANDSOR SANITARY - SEWER LATERAL 'FIELD LOCA DATE. CONSTRUCTION: ADDRESS STREET Z� SUBDIVISION:ro No ■■ 'fir. � ■■ ■ ,,: ,,,■!� ■■ � MEN ■ ■■ ■■ ■■■■■ME ON 0 ■■■■■_ I■■■ ■■ ■ ■■■ ■■ l' ■■ ■■ ►. ■ fM� _ ._ _.__■ ■■■■■■►I ■■■ a■ ■■■ �, ■�.' ■ ■■■■■r■r■ ■ ■ ■ ■ �■ �D>, '1 low ■ A 0 f 1i • DD• +w D, O D' 1 TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: ���' ` `2C)C-)Ll BUILDING ADDRESS : LcYT 12- STREET -E- SUBDIVISION: NORTH ARROW SLY EwlsrW6 W _ E v,, V, e 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