HomeMy WebLinkAboutDrain Layers Permit 21 Welles Lane (2) a
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. . 6875 Contractor WILCOX, MICHAEL (EAGLE)
Location 0021 WELLES LANE Address EAGLE EARTHWORK SERV.
Type Work NEW SAN LAT 101 N MOUNTAIN ROAD
CANTON CT 06019
Phone, ,No,.<. (860)693-2027
Date Insp Needed Date� Insp<i,
Time Insp Needed
Ti ►e 'Irsp.
Inspected By
Work in Progress
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I"hput Date
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Permit No. 6875 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) r X 2 LLES LANE
Addr. EAGLE EARTHWORK SERV. Ow' r L E REGINA M ET AL
101 N MOUNTAIN ROAD
CANTON CT 0601:9
Phone No. (860)693-2027
The Drain Layer ass d th; per, it has a ua i,di 1 tense issued by the
state and hereby ag �s t, "Al.l he ' terMs and 6and;1ti'ans set forth in the
attached 'Condit ' s' : A 1 l o,rk sha t 1 :b�` i n acoor'dah&ee' with Town of South
Windsor stand s, al1 `OSH equirements,: and ate attached conditions.
Issued By ,Titl�e
Date Inspected Inspected By
APPLICATION FOR DRAIN LA
YERS TOWN OF SOUTH WINDSOR PERMIT
PUBLIC WORKS DEPARTMENT
1* 4 S
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work Z / /
Ii5 G2�-
Premises owned by: ��c� t c Street No. Street Name Lot #
Name of Firm:
Address of Firm: p 41 Phone:
---------------
TYPE OF WORK.
Lay House Drain-Z--: Repair Ho
Lay Main in
Lay Lateral or
Building Of--- acre f
-- ercial/Industria.l
Connection will be made with �1
Proposed Start Date��� Esti ted ime for completion
P n _ZZ-
ALL WORK TO BE IN AC O
STANDARDS, ALL OSHA RE I CE WITH TOWN OF SOUTH WINDSOR
THE PERMIT 11�ENTS AND CONDITIONS ATTACHED TO
Permit is to be issued toLLL�layer's License No. �� y the holder of Drain
issued a permit. permit will expireO thirty holders y Pl, P7 8& W9 licenses will be
undersigned Drain Layer hereby agrees to a1�the terms
after date of issuance. The
in the permit and attached thereto. terms and conditions set forth
Excavation Permit No. APPlicant has received Town Street
and/or ConnDOT permit No.
Signed:
Licensed Drain Layer Print Name ,C6iCdE
C' v�
Date: 1 _i