HomeMy WebLinkAboutDrain Layers Permit 55 Stedman Circle (2) APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH WINDSOR �-
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work: ]�� �1CG� ���C f Lot #
Street No. Street Name
Premises owned by: ( 1 ` lm,
Name of Firm: *4�E F;, Phone:
Address of Firm: 0/ /1 0 41 -fl60 Fa 14
TYPE OF WORK: (�(
Lay House Drain V Repair House Drain ;
Lay Main Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with �/ yn
Proposed Start Date 12 M Estimated time for completion T
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 a r'1,6�l �° l �� `C D 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.
Signed: Print Names
Licensed Drain Layer
Date: l � - � 9?
rm t N6. 6852 Town of South Windsor, CT
rmit Date 07/13/1998 Drain Layer Permit
piration Date 08/12/1998
scrip: PRORATE SEWER CHARGE PAID CK 1925
Applicant Location
one WILCOX, MICHAEL (EAGLE) 1 Addr 3p0 5 STEDMAN CIRCLE
Jr. EAGLE EARTHWORK SERV. .� LOZI REGINA M ET AL
101 N MOUNTAIN ROAD ` z
CANTQN CT bo'
one No. (860)693-2027
The Drain Layer as� ense issued by the
State and hereby agre d � set forth in the
ittached 'Conditions' a rk A f " ac aWq with Town of South
Vindsor stancLords, alu,
.
p ched conditions.
sued By
:e Inspected s