HomeMy WebLinkAboutDrain Layers Permit 11 Welles Lane Permit No. 6797 Town of South Windsor , CT
Permit Date 04/30/ 1998 Drain Layer Permit
Expiration Date 05/30/ 1998
Descrip :
Applicant Location
Name WILCOX, MICHAEL (EAGLE ) Addr . 11 WELLES LA
Addr . EAGLE EARTHWORK SERV. 'O`wlnner', MANNARINO BUILDERS
101 N MOUNTAIN ROAD
CANTON CT 06 YA 9
Phone No. (860 )693-2027
The Drain Layer asSiyr7ed ,th 1;s permit has a Ya1;id -1 ic:ense issued by the
state and hereby agrees to\' ai.i 'the ' ttrms and contitid'ns set forth in the
attached 'Cond it ions ' . -A] "'work sha 11 -"be , ac �or'd'ahce` w i th Town of South
Windsor standards , all OSHA r0quirements, and the attached conditions.
Issued By -_--- `a—/ ".��: 1` tleJZ
Date Inspected Ins eotet 8 _.-._--
p -- -----------_ p y
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 6797 Contractor WILCOX , MICHAEL ( EAGLE )
Location 11 WELLES LA Address EAGLE EARTHWORK SERV .
Type Work NEW SAN l_AT 101 N MOUNTAIN ROAD
CANTON C',T ( f�019
Phone No: ( 860)69,3-2Q27
Gate Insp Needed l �f r_ mate Tnspa
Time Insp Needed ,��'- _.� `?� _ Time Irtsp• -��� _ __- ---
Inspected By
Work in Progress
%fir
--__
. _ f J
Input ` `_�� `- Date --
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION:
BUILDING ADDRESS
STREET
-I- SUBDIVISION: IL kd�
NORTH ARROW
I 1 i i I i
i
I
J.
I I I t {
_L L_
-
! ITA
r i I i I l 1
I I '
;
I
I
s
1
i
PI i
t i
o G� se`v, (, /co
v�
CONTRACTOR RINT) NAME dr CON CTOR'S SUP RVISOR (PRINT)
STREET ADDRESS SIGNATURE
�Gxor✓ C Q 6U l y DATE
TOWN STATE ZIP INSPECTED BY TOWN
( @UG) K�5 - ,-2o � -Z DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
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: Lj�l L 40,6 Lot # 3
/�,� Street No. Street Name
Premises owned by: / I A 'A e*A5
Name of Firm: 9 Phone:
Address of Firm: /0/
TYPE OF WORK:
Lay House Drain ; 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 S �p
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR
STANDARDS, ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO
THE PERMIT
01
Permit is to be issued to A ���l I lCoxthe holder of Drain
C
layer's License No. 2 76//G Only holders of PI, 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 /"! " C00(
Licensed Drain Layer
Date: