HomeMy WebLinkAboutDrain Layers Permit 15 Stone Crossing ` TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. Contractor WILCOX, MICHAEL W.; 7,
Location , -&' (EAGLE)
EARTHWORK SERV.
Type Work NEW SAN LAT Address EAGLE E I
101 N MOUNTAIN ROAD
CANTON CT 06019
h ►n No. (860)693-2027
Date Insp Needed 1 `7
Time Insp Needed
a`, Ai
Inspected By
Work in Progress s
Sewer P�n•n�
s® a n
T
CanCrsde-
t Date 0
OthefvA t No. 7495 Town of South Windsor, CT
Pe`rmit .Date 08/27/2002 Drain Layer Permit
Expiration Date 09/26/2002
Descrip:
Applicant Location
Name WILCOX, MICHAEL KIP � 5 STONE CROSSING
Addr. EAGLE EARTHWORK S NARINO BUILDERS
101 N MOUNTAIN R
CANTON
Phone No. (860)693-2.
i
The Drain Layer
t h license issued by the
state and hereby a al s a ions set forth in the
attached 'Conditio iQlpd nce with Town of South
Windsor standards, re ttached conditions.
cc
-41
f
Issued By
• Ma
Date Inspected n d By — -
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL . FIELD LOCATION
DATE OF CONSTRUCTION: :5-/, /0-
BUILDING ADDRESS .�
STREET
+ SUBDIVISION:
NORTH ARROW
f
_.. _ .
r
pp
1
I ! 1 0 { E
f
i
3
'�i�tt1 r 1 C
1 �7W l 1 - 1 i z �E✓ Q(('yy1��
! i 1
1 ! r 1
if
1 I t f t : 4 f
i 1
,
' 1 1
i
' I
I I i y
'S yvis0r�Q-
CONTRACTOR (PRINT NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
C'1 �
STREET ADDRESS SIGNATURE
TOWN STATE ZIP INSPECTED BY TOWN
9/o 6 SPl 11),Q-3 f DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: T, `3a-®o�
BUILDING ADDRESS e �i
STREET
SUBDIVISION:NORTH ARROW `Z�
--
1
i if
(36
r
} i
r
i
t ' ,
i ..... _.. _ . l
f j
n
tf r j )j
t 1
-- I
'
iL
V. &C,
i t ..J.-""--F. __.1...__ - ' j V - i. -,'.LJ':."..4+/•.. .__. I _...._...._. j-._._ _..........___.__L.�.._.__--- t
1 i
Woe, c d
CONTRACTO (PRINT)L�" N E OF 0 TRACTOR'S SUPERVI R (PRINT)
STRE ADDRESS SIGNAT RE /
DATE
TOWN STATE ZIP INSPECTED BY TOWN
L%-202,1 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: Lot #�_
Street No. Street Name
Premises owned by: Mai. q li1 Q^6 k� LC6ey�
Name of Firm: J54:6J_ is gt4fi71-W6k Phone: 5j_'?10Z7
Address of Firm: /01 Awf� &do�itotlll
TYPE OF WORK:
Lay House Drain_; Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with L
Existing.Water Supply: Public Water. Well
Proposed Start Date , -v 2 Estimated time for completion _ 9
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 , l&CL el /� X. the holder of Drain
Layer's License No. Z 70j&g Only holders of Pi 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 Cor�nDOT Permit No.
CBYD No.
M
ot
Signed:69V2V*11fj4WPrint Name: `e�i V f ` 0
Licensed Drain Layer
Date: 6�77 '1d2�_
Standard Forms\Permits\APPLICATION FOR DRAIN LAYERS PERMIT.doc