HomeMy WebLinkAboutDrain Layers Permit 83 Joseph Lane (2) i
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7790 Contra68t WILC.0X,..MICHAEL (EAGLE)
Location OD83 JO$Eft LANE dre�s EA. 'LE EARTHWORK SERV.
Type Work NEW SAN LAT
1:.0..:1 N M4L7NTAIN:::..ROAD
CANTON CT 0.6019
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F�lion� No {8.50)693-2027
Date Insp Needed ____ Data Ird p
Time Insp Needed Time 1
Inspected By >:
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Work in Progressiz �t9ir
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Permit No. 7790 Town of South Windsor, CT
Permit Date 08/11/2004 Drain Layer Permit
Expiration Date 09/10/2004
Descrip:
Applicant Location
Name WILCOX, MICHAEL (EAGLE) Adder 0,4.83 JOSEP�T LANE:::
Addr. EAGLE EARTHWORK SERV,; Ow .e _:.MANNAk'INO. DUTLDER'S INC
101 N MOUNTAIN'RQAD
CANTON CT 06019 .-
Phone No. (860)693 20 7
The Drain Layer'48-s.2gried this e ( t has a ualad license-»ss'ued by the
state and hereby agrees to all:-:;.the terms and conditxons set.::forth in the
attached 'Conditions' :' All word sh ,be in aocoxdarce with Town of South
Windsor standards, a7,1 OSHA eguize05.4: a; au. the attachcd'c.. nditions.
Issued By --- � � Title t �U
Date Inspected Ins ected B l�P�r
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: ^ Lot # 1
Street N Street Name
ises-awned-bp. "
Name of Firm: Phone:
Address.of Firm: /0/ kVd.
TYPE OF WORK:
Lay House Drain-_; Repair House Drain
Lay Main ; Lay Lateraf for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Water_ Well
Proposed Start Date _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 _ M 6 e,ki i! W i l Co k the holder of Drain
Layer's License No. Z 8! 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. (Print Name: ���0,�
Licensed Drain La er
Date: -/l'0
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERSPERMIT.doc -
TOWN - OF SOUTH WINDSOR
SANITA,RY - SEWER LA.TERAL 'FIELD LOCAT.10N
DATE OF
BUILDING ADDRESS •
STREET
SUBDIVISION: ! �v
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TOWN OF SOUTH ANDSOR
SANITA RY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 3UAJ'i
BUILDING ADDRESS Lo
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