HomeMy WebLinkAboutDrain Layers Permit 102 Joseph Lane I
TOWN OF SOUTH WINDSOR INSPECTION REPORT
#Permit No. 7788 Con:trac'tor WILCGX ::-MICHAEL (EAGLE)
Location 074$ a06li SE AcidresS EAG€,E <'EARTHWORK SERV.
Type Work NEW SAN LAT " 1,.0,:1 N"MOUNTAII'.;ROAD
CANTOfI CT 06019
Phone No 4,$_60}S93 2027
Date Insp NeededDate Lisp
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Permit No. 7788 Town of South Windsor, CT
Permit Date 08/11/2004 Drain Layer Permit
« Expiration Date 09/10/2004
Descrip:
Applicant Location
Name WILCOX, MICHAEL (EAGT,E) Addy 0162 J"OSEPH LAME
Addr. EAGLE EARTHWORK SERV Owner MANiIA12IN -BUILDERS INC
101 N MOUNTAIN ROATY•
CANTON CT.:. 06019 `
Phone No. (860)693 202
The Drain Layer: assigned this per...mit ha'G a valid license'issued by the
state and hereby agrees <.to aXl the t!ems :and A4... ditirns set. forth in the
attached 'Conditions' All wotk slta]l be -in aCOO
rdance with Town of South
Windsor standards, all..a::OSHA reu�rm; sts, :and..the attached `conditions.
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Issued B TitiY Uu
Date Inspected ' Inspected By
7 -7
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: d6 t2, Lot # _
Street No. Street Name
Pre-mises-own -
Name of Firm:-F, - a Ae- Phone: -00Z 7
Address.of Firm: �!
TYPE OF WORK: M
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 �44 Estimated time for completion C5 -r.
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 �C �! the holder of Drain
Layer's License No. 7-7-9116 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: Gl/ Print Name: VC66
Licensed Drain Layer
Date: f"f —e 7
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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CONTRACTOR (PRINT) NAME OF CONTRACTORS SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER