HomeMy WebLinkAboutDrain Layers Permit 49 Stedman Circle '" TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 6871 Contractor WILCOX, MICHAEL (EAGLE)
Location 0049 STEDMAN CIRCLE Address EAGLE EARTHWORK SERV.
Type Work NEW SAN LAT • 101 N MOUNTAIN ROAD
CANTON CT 06019
Phbne: NQ: (860)693-2027
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Itit Date
Dermit No. 6871 Town of South Windsor, CT
Permit 'Date 09/17/1998 Drain Layer Permit
Expiration Date 10/17/1998
Descrip: CK4359 LTS10, 11 , 12, 16 ,22 PMT 49 , 55 STEDMAN
Applicant Location
Name WILCOX, MICHAEL (EAGLE) 4ddr , .00549 STEDMAN CIRCLE fir"
Addr. EAGLE EARTHWORK SERV. , `Owner 'B.LOZIE REGINA M ET AL
101 N MOUNTAIN ROAD
CANTON CT 06:O fig
Phone No. (860)693-2027
The Drain Layer assigned `this per.mf t=..has a Va.l`i d 1._i dense issued by the
state and hereby agrees-to :all' the terms and cohditfon� set forth in the
attached 'Conditions' . All v�c�,�k shall ,b, : i,n accor�ance' with Town of South
Windsor standards, all: OSHA`�._ ®qu'� aeC�ts .,And the�attached conditions.
Issued By
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Date Inspected �°( �. _ ► , p
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TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: st 4e /r
BUILDING ADDRESS /off # �®
STREET fir"
+ SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CON ACTOR'S SUPERVISO (PRINT)
STREET ADDRESS SIGNATURE
TOWN �j STATE ZIP INSP CTED BY TOW
Z� 6"0 DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
• 68s-o ��
k APPLICATION FOR DRAIN LAYERS PERMIT pR
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT �8
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work 45 )tC-'�i 4j a/) Lot # 20
Street No. Street Name
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Premises owned by: &764 V d 0 ,hc1�� o� 5
Name of Firm: 4�; 6LE 1 & De, Phone: (� j, --?��?7
Address of Firm: 10 C X ey J:�
TYPE OF WORK:
Lay House Drain P Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made witfil�,(�
Proposed Start Date-2�-o 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 t c[14C e/ ( G CSC the holder of Drain
layer's License No. _2,7811(o . Only holders of P1, P7 & W9 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.
Signed: — Print Name ^64�t,57(
�-�C�
Licensed Drain Layer
Date: l 'r�