HomeMy WebLinkAboutDrain Layers Permit 15 Welles Lane Permit-,No.' 6874 Town of South Windsor, CT
Permit Date 09/17/1998 Drain Layer Permit
Expiration Date 10/17/1998
Descrip: CK4359 LTS10, 11 , 12 , 16, 22 PMT 49, 55 STEDMAN
Applicant . Location
Name WILCOX, MICHAEL (EAGLE),,, Addy^.; 00 k WELLES LANE Low �z
Addr. EAGLE EARTHWORK SERV. wrvo B OZ REGINA M ET AL
101 N MOUNTAIN ROAD
CANTON CT 060j,
Phone No. (860)693-2027
The Drain Layer assigned, thls permtt _has a ya1id: 1fcense issued by the
state and hereby agrees to all�.`the terms and doh, i'tii�n set forth in the
attached 'Conditions". .Al l"„'work shall bc ['n acpurdara, e�� with Town of South
Windsor standards, al 1 OSHA hed conditions.
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Date Inspected 9��.8��"v ,, Znspec d ,BY
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 6874 Contractor WILCOX, MICHAEL (EAGLE)
Location 0015 WELLES LANE Address EAGLE EARTHWORK SERV.
Type Work NEW SAN LAT 101 N MOUNTAIN ROAD
CANTON CT 06019
Phone .No (860)693-2027
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Input Date JT/Asc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: f c)en. -ze> `gqf
BUILDING ADDRESS 15 Wr!: 5S LAmFE
STREET : tar 1Z
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CONTRACTOR RINT) NAME CONTRACTOR' SUP RVISOR (PRINT)
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STREET ADDRESS
LL SIGNATUR
✓1/7J DATE
TOW STATE ZIP INSPECT BY TOWN
-2 DATE
T HONE N BER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER
v APPLICATION FOR DRAIN LAYERS PERMIT 6-67Y
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work -/,5�_ 6 /,-q- �zcs of #L 2-l
Street No. Street Name
Premises owned by: 4pll lvl],�
Name of Firm 0RfA Phone:
Address of Firm: a4g
TYPE OF WORK.
Lay House Drain _; Repair House Drain ;
Lay Main ; Lay Lateral for CommerciaVIndustrial
Building of acres
Connection will be made with
Proposed Start Date _zo 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 the holder of Drain
layer's License No. Z7 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.
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Signed: ���" !Chw Print Name d l L ie
Licensed Drain Layer
Date: ��