HomeMy WebLinkAboutDrain Layers Permit 558 Nevers Road (2) i
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7796 Con:tr`actor WILC`OX ....;MICHAEL (EAGLE)
Location 0558 NEVERS ROAD EAGLE "EARTHWORK SERV.
Type Work DIS SAN LATA:l N MOUNTAhN..;ROAD
CANTOIT'.:CT O:b019
Phone ,No {;8.60)69.3 2027
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Date Ins
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,Date Insp Needed _-
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Time Insp Needed T;me Insp
Inspected By _
Work in Progress
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Permit No. 7796 Town of South Windsor, CT
Permit Date 08/11/2004 Drain Layer Permit
Expiration Date 09/10/2004
Descrip:
Applicant Zcation
Name WILCOX, MICHAEL : .(EAGLE) A0.
dC 055:8 NEV
ERS ROALY:..
Addr. EAGLE EARTHWORK SERV, Qsaher DESPARD .W..'ENDI J
101 N MOUNTAIN:ROAD
CANTON CT 06019
Phone No. (860)693 1027
The Drain Layer:: assigned this pex:ittlt has a V lid IIcense::::is5ued by the
state and hereby agrees to all.. the terms and cohdi.V10 set._forth in the
attached 'Conditions' All word sha7: }34 xx� acco"rdarice with Town of South
Windsor standards, all OSHA r .quire ierits - ..and the . , diti.. nons. ;
i
Issued By Tate
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By
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Date Inspected ______ "Tnspeo'ted
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR G
PUBLIC WORKS DEPARTMENT
TOWN HALL .
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
` FEE $60.00
Location of proposed work: ss8 P ll�°�S Lot #
Street No. Street Name
Premises owned by: Man ei%o p hvf`�
Name of Firm: y
-Phone: 'Zaz7
Address.of Firm:la/ tPub'#! Pd#4t4i` 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 r pVe,
Existing Water Supply: Public Water__ Well
Proposed Start Date 7,101 Estimated time for completion ' 2 no
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 /�ee lid 1 14A,"1 e y the holder of Drain
Layer's License No. z7-0 it(* 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.
401WSigned: W Print Name:
Licensed Drain Layer
1 Q
Date: U^l L` 4
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
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TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEE, / DEVELOPER