HomeMy WebLinkAboutdrain layer permit 1127 Sullivan Avenue a
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 7705 Contr66T WILCOX CONSTRUCTION CO(DARRYL)
LocationMWA ' Addreso _ 53f ODD; A-.F FORD ROAD
Type Work NEW SAN LAT .:___, ..OLLAND,CT .06OQ:4
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Date Insp Needed Date y _
Time Insp Needed w)N CA1 p
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Permit No. 7705 Town of South Windsor, CT
Permit Date 01/12/2004 Drain Layer Permit
Expiration Date 02/11/2004 `>
Descrip: M
Applicant y
pP xy. .C�C::ion
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Name WILCOX CONSTRUCTION CO DARRY,) A i 1L27 S�JLLIVAN AVENUE
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Addr. 535 OLD STAFFORD ROAD? Lls3;k . ...GOIANC�44S add JR "� CLAUDIA A
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TOLLANDT 0>6Q$4
Phone No. (860) 871-1839
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The Drain La er::assi y gie b3is y3tka � id ense rosued by the
state and hereby ag e to ill: the terms and condatlpYa` seb:::foith in the
attached Condrtions. All wt�: I shaZ�# , �Yicord�rieiith Town of South
Windsor standards, al::l OSHA''i::rb, ui EFF[ y . `. ;i.:: xi "£h.e a.;t.: �rche`rk< 'csnditions.
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Issued By v+ �Lf✓�� T�f3e .,: {"�" +^'\y
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Date Inspected -------------------- Inspected By _—__----
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APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR 4771,
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: . `d: . �'�� v ��f��iot #
Street No. Street Name
Premises owned by:
loe-
Name of Firm: K-� ZZ:z' Pho
Address.of Firm: 5� d �S' /—/-'"cc✓ �sG''i�
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TYPE OF WORK: ��.
Lay House Drain __; Repair House Drain
Lay Main ; Lay Lateraf for Commercial/Industrial
Building of acres
Connection will be made with /,i7�/� hC,�
Existing Water Supply: Public Water Well
Proposed Start Date l o stimated time for completion Z�i'le� c
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 �,GV11- the er of grain
Layer's License No. Only holders of P-i �r W-9 licenses
will be issued a permit. PERM 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.
Signed: rint Name: rir � -�G "
Licensed Drain Layer
Date: � O
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