HomeMy WebLinkAboutDrain Layers Permit 558 Nevers Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
` Permit No. 7794 Contractor WILCOX -<;MICHAEL (EAGLE)
7 Location 0558 NEVERS ROAD "Addr:e$,s ;`:: EAG.LE;;LARTHW.QRK SERV.
Type Work RPR SAN LAT 30:1 N MOUNTAIN>:ROAD
6ANT6N;GT 06019
Phone`.No :8.60)693 2027
Date Insp Needed ------------- -- Date Lisp
Time Insp Needed Time no.------------------
Inspected By All
Work in Progress
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input Date
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Permit No. 7794 Town of South Windsor, CT
Permit Date 08/11/2004 Drain Layer Permit
Expiration Date 09/10/2004
Descrip:
r Applicant Location
Name WILCOX, MICHAEL (EAGLE) Addy 0558 NEVERS ROAD
Addr. EAGLE EARTHWORK SERV OWPzr 2)ESkARD V7:ENRT J
101 N MOUNTAIN ROAD' .
CANTON CT 0019
Phone No. (860)693-2027
The Drain Layer assigned this permit haS a valid lcense.. isaxed by the
state and hereby agrees to all Che terms and c�tnditi0ns set,.,foxth in the
attached 'Conditions' ...Al] Work shall be ,in aecrrdane with Town of South
Windsor standards, a11 `OSIA requzremtrtts;. -and tie attached conditions.
Issued By ---C Title = ------------------
77
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Date Inspected �- _ Inspected By , -v-
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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: ss� _UPS Lot #
Street No. Street Name
Premises owned by: ahH jef(ii D
Name of Firm: -�
Phone•
Address.of Firm:_ 10/ A)hl� PAV4U`l
TYPE OF WORK:
Lay House Drain_; Repair House Drain
Lay Main ; Lay Lateral-for Commercial/Industrial
Building of acres
Connection will be made with pvc
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 the holder of Drain
Layer's License No. Z7-0 It6 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.
G!/ r r `
Signed: ! Print Name: / I�C� �r( IA! r CD
Licensed Drain Layer
1
Date: U^ L`D 4
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
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_ TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
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