HomeMy WebLinkAboutDrain Layers Permit 79 Kupchunos Drive TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 8003 Contr'a'ctor., ..ZL O ;;"-- lCHAEL (EAGLE)
Location 0079 KUPCHUNOS DRIVE AdCit. ss E1 L, FAR3IWflRK SERV.
Type Work NEW SAN LAT
MOb PZIN"ROAD
ii4TOL� 0r 0C.019
on .;,Ph e Nc (B�q�)693 2027
f
Date Insp Needed ------------- __ date Ir 6 r
Time Insp Needed ---------- F fine Otisx s
Inspected By
: F
<. f
f
Work in Pro ress �;�.�lvt �I tt�Lt
s ---- r—�
:
�� 7D VW l'+ Input bate_�N
' I
1
Permit No. 8003 Town of South Windsor, CT j
Permit Date 11/18/2005 Drain Layer Permit
Expiration Date 12/18/2005 i
.. i
Descrip:
Applicant Ltcscaion
I
i
Na
me WILCOX,
I COX MI CHAEL:< � :
( q )- Ad�R~ � 0079 KUP_CRiUNOS bRIVE
Addr. EAGLE EARTHWORX SERV Owrier KUPCH NO ?.>3USAN M.
101 N MOUNTAIN; RROAD
CANTON CT 0.6_019
Phone No. (860)693 2027'
* a
The Drain Layer; assigned this p6 tnUt had valid 7.3cense`'3.ssued by the j
state and hereby agrees to all the tertYtsrtt conditions set forth in the
attached 'Conditions' A11 work sha :l a:0,c:oxdance Avzth Town of South
Windsor standards, all �.SHA requirement - .:.aY�d the dtt::acied.conditions. 3
------�-- — �—
Issued By,
Titles^
Date Inspected --_ Inspected By
r
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, Cr
FEE $60.00
Location of proposed work: 7 v C v o
An Lot #moo _
Street No. Street Name
44
Premises owned Di Y: MA A thA D
. Name of firm: � o Phone:1Q5
_.
Address-of Firm: /0 f A)n,& I,
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 f L 2-1— Estimated time for completion t 1-z�{
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_A" rl, a�( �,/,'G
the holder of Drain
Layer's License No. Z 2 A/ 1 Only holders of P-i, 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.
i
Signed: W / I
Print Name:_/ !t 4�� fiV d f Eo K
_Licensed Drain-Layer----,---- --- ----- — ---- -
Date:- 11_
Standard Forms\Permits\APPIICKTION FOR DRAIN LAYERS PERMrr.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCAT.10N
!ATE- OF CONSTRUCTION:
w
BUILDING AbDRESS
STREET /
SUBDIVISION:
i• '1
ASRAqW
■■ ■ ■ ■■� ��■■ _ i � �1 f it 1 1 � I ■ ■
■■■■►�/ ■ err''' f� �■�. ■r�,,,�■■ ■
r ®�
1/
KTL MT
11'
• 1
1 1 1• / 1 ! 1' •