HomeMy WebLinkAboutDrain Layers Permit 5 Stedman Circle 0
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 6951 Contractor WILCOX, MICHAEL (EAGLE)
Location 0005 STEDMAN CIRCLE Address EAGLE EARTHWORK SERV.
Type Work NEW SAN LAT 101 N MOUNTAIN ROAD
CANTON CT 06019
Phone 'No. (860)693-2027
Date Insp Needed d Duets Ir1s 2 9 9�
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Time I nsp Needed + T i Me' I'ns AS NaT�D
Inspected ByPEQNA
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Input Date
Permit No. 6951 Town of South Windsor , CT
Permit Date 02/17/1999 Drain Layer Permit
E-xpiration Date 03/19/1999
Descrip:
Applicant Location
Name WILCOX , MICHAEL ( FAG ) { Ads b#Q05 STEDMAN CIRCLE
Addr. EAGLE EARTHWORK SERV, _, r '� rlOLIE REGINA M ET AL
101 N MOUNTAIN RQAD � z
CANTON T '�9 : A
Phone No. (860)693-207 �
The Drain La Y er a�Q�i t
h,fs p$rmi:, hay. 0 1 i cease issued by the
state and hereby agres1 any # �i Mo
e ns set forth in the
attached Cond i t i one}�.:_ h O o� h i n ft) dajhce with Town of South
Windsor standard 1 1 b reirjtr r frtn� t . lie attached conditions .
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Issued By
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Date Inspect -1f919°J d5p4cted By
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: r4aig
BUILDING ADDRESS fi
At 1,5
STREET . SA C►r��C
70-
SUBDIVISION: � n
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
144-4
STREET ADDRESS SIGNATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
LsLo y U -7 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
APPLICATION FOR DRAIN LAYERS PERMIT6-1
TOWN OF SOUTH WINDSOR _`
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00 25_
Location of proposed work �,/ ZEMA/Y Lot #
Street No. Street Name
Premises owned by: ydow `r ✓ ��° y
Name of Firm: 1� Phone: 2c02-7
Address of Firm: D Q
TYPE OF WORK:
Lay House Drain ; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
l( U
Connection will be made with (f1
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
TO
THE PERMIT
Permit is to be issued to 111(IG C'e( b)1 4ea the holder of Drain
layer's License No. Z7,9/�6 . Only holders of Pl, P7 & W9 licenses will be
issued a permit. Permit will expire thirty (301 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.
C o
/ / `� )
Signed: Print Names, � 4'( Ali leax
Licensed Drain Layer
Date: 2 ��