HomeMy WebLinkAboutDrain Layers Permit 5 Stone Crossing TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7592 Contractor WILCOX , MICHAEL (EAGLE)
Location ;OIV Address EAGLE EARTHWORK SERV.
Type Work NEW SAN CAT 101 N MOUNTAIN ROAD
CANTON CT 06019
No. (860)693-2027
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Permit NO. 7592 Town of South Windsor, CT
Pe`rpmi t"-_ ate 10/30/2002 Drain Layer Permit
--Expiration Date 11/29/2002
Descrip:
Applicant Location
Name WILCOX, MICHAEL (EA ) Aid . STONE CROSSING
Addr. EAGLE EARTHWORK SER r<MA ARINO BUILDERS
101 N MOUNTAIN ROA
CANTON C
Phone No. (860)693-2027
The Drain Layer s i a icense issued by the
1 an ns set forth in the
state and hereby ag e
in a e with Town of South
attached 'Condition ached conditions.
Windsor standards, a
Issued By h a
n y
Date Inspected
TOWN OF SOUTH WINDSOR
SANITARY, SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET :C'
SUBDIVISION: S�
NORTH ARROW
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CONTRACTOR ( INT) NAW 0 CONT TORS SUPERVISOR (PRINT)
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TOWWNN� STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPEI
TOWN OF SOUTH WINDSOR
SANITARY" SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: fir` t. Z
BUILDING ADDRESS L n`
STREET r S L � r
-I- SUBDIVISION:
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
DATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: 6 elt-f7-5;9 Lot #
Street No. Street Name
Premises owned by: atim q(' ba Avi}&!e
Name of Firm: &L rtAW Phone:
Address of Firm: lD` `tk Mjoo -
TYPE OF WORK:
Lay House Drain_; Repair House Drain -6- ;
Lay Main Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with �Ovnv'
Existing Water Supply: Public Water Well
Proposed Start Date--IP 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 A 6C(tad 4)tl'w L the holder of Drain
Layer's License No. 7,7 0!16 . Only holders of P1 or P7 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.
n �t F
Signed: Print Name: I 01)66�'
Licensed Drain Layer
Date: to- 5 0-01�—
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc