HomeMy WebLinkAboutDrain Layers Permit 94 Joseph Lane • TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7858 `>'
Cont. tOr WILC63K":-N-JCHAEL (EAGLE)
Location 0094 JOSEPH LANE °`
,f��`dres;�' �a�AGL �'ERT SERV.
Type Work NEW SAN LAT JN'' ,; ,n .3.•N�M�SUN�IyALN 1tOAD
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Permit No. 7858 Town of South Windsor, CT
Permit Date 11/08/2004
T; Drain Layer Permit
Expiration Date 12/08/2004 'f`'
Descrip: LAY HOUSE DRAIN
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Applicant
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Name
WILCOX, CHAEL
MI
Addr. EAGLE EARTHWORK.;SERVr MANNARJQ $T3ILDER INC
101 N MOUNTAINZO:Ar;
CANTON c,:.:z3.
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Phone No. (32 :693-2 860 : n>
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The Drain Layerd'�. �ri'We-: pjsi.ed by the
state and hereby ag e <. ' z " rms` Y] r ".s
:>>t4`": '`<.the` cT cor'i3 o th in the
attached 'Condi tions:i;.:>:Hr:" s:` <ty" . a2d tk `T`oan of So
uth
Windsor standards, al'41, OSIA"`- 9Ftui3` nt�it °:s i e1' ge atka' tie" ..coziditions.
Issued By - :.. °Iil. :�. `
Date Inspected ____------_—__—_ Iri�jL��'c�`">By
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 # 3
Street No. reet,Name
Name of Firm: /e, V`fA Phone: �q�7dZ7
Address of Firm: ZO ( AV7% M0 MiaL`PL �Ct L1,t
TYPE OF WORK:
Lay House Drain °� ; 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 C Estimated time for completion l�
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
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Permit is to be issued to � Wv!t°0 6C -the holder of Drain
Layer's License No. z 7e Z . 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: �(J Print Name:_ �"I V�, ( li(/ lib
Licensed Drain La er
Date:_
Staridard<Forms\Permits\APPLICATION FOR:DRAIN LAYERS PERM1T.doc: -
TOWN - OF SOUTH 1 , •
FIELD LOCATION
SANITARY SEWER LATERAL
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BUILDINGb!�T qq
ADDRESS
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 7QAJ�
BUILDING ADDRESS
STREET In P NE
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 f DEVELOPER