HomeMy WebLinkAboutDrain Layers Permit 49 Stedman Circle (2) erm- tp N� 6850 Town of South Windsor, CT
ermit Date 07/13/1998 Drain Layer Permit
xpiration Date 08/12/1998
escrip: PRORATE SEWER CHARGE PAID CK 1925
Applicant Location
ame WILCOX, MICHAEL (EAGLE). A c Q049 STEDMAN CIRCLE
dr. EAGLE EARTHWORK SERV. -Owner Bl.(}?IE REGINA M ET AL
101 N MOUNTAIN ROAD �t
CANTON
lone No. (860)693-2027
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The Drain Layer _ash .' s ; f cf. tcense issued by the
state and hereby agre s # end itIo set forth in the
attached 'Cond i t i ons' 4 Y `rk h trdceQ with Town of South
Windsor standar s all .. rq C�� + f 'G�, and aGtched conditions.
,sued By
l
tte Inspect
` APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL �g
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
f proposed � ( j?�JXI Lf���l 1 Lot #Location o ro osed work: v1 ;—d
Street No. Street Name
Premises owned by: I lan 4 a if,,n 0 U c
Name of Firm: b Phone:
Address of Firm: &I fl 10 U lz ' 6
TYPE OF WORK:
Lay House Drain �L Repair House Drain ;
Lay Main Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
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 / I t Gf 0 ell 6L10- o x- the holder of Drain
layer's License No. 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.
l 4�
Signed: Print Name
Licensed Drain Layer
Date: �.