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HomeMy WebLinkAboutDrain Layers Permit 14 Stone Crossing TOWN OF SOUTH WINDSOR INSPECTION REPORT Permnt No 8128 Cor}-ractor,WILC.Q,}C, N,1..:QHAEL (EAGLE) Location 'cld ,e it:EAG'B'�}Z�, FAkTI;IW R�C SERV. "° �`� Type Work NEW SAN LATE t 3 p j�IOUi] AI£N K(aAD a^z 7ry; ?' +z y"-jo n19;..;yy Y ' ;,a:.6;g`3,-It2©2 y. Da te Ins p Needed j' o. 'T Time Insp Needed ,,T_.-:m raA:? yfy' 3 Inspected B e Y Work ,...,. in Pr s o res 1 qb f f i : y yy: Icy ------------ k 746 .J nuy •qw InpiYk �a ---- -------------- I Permit No. 8128 Town of South Windsor, CT Permit Date 12/11/2006 Drain Layer Permit Expiration Date 01/10/2007 Descrip: INSTALL SEWER LATERA `f °.' .Y .yu: ♦fAt%. / . Applicant LjC" 'ipn �'=...,,..: ,•may' WILCOX, MICHAELName x £ y Addr. EAGLE EARTHWORK iERV. 1, '+ Y„y,.SyT JOHLqi.---1�1I+I�i NCE &;. MARY ELLEN N MOUNTAIN '0.� 101 a:!> : > ` CANTON `c. ."os G 1 Phone No. 8 60 693 20. nfy.' I: the The Drain Layer s's' `gri��:yV irhi�.s"k?� �i"hs�'s,;`��x:;::>;�t` :��:�• y� 4 Y state and hereby agr � tae '4he `term's`'and cori `,tbn '<'s,: tagrth in the attached 'Conditions : "VA11 �cz�lr 4.s1;��`7�.��:�� ��of:Si�?�i�� W�Z'h Tb�vn of South Windsor standards, a 1 IL 0S94A "Ve', ditions. 1 >: Issued By ,:. -----� ------------------- Date Inspected Ins ected B l TOWN OF SOUTH . WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS , STREET -�- SUBDIVISION: NORTH ARROW ---------------- r - ' i 4 I p 1 ii i I 1 E t S i ! I� ~I^ i CN i I : f' . • • I ` +y , 3 r CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT) STREET ADDRESS SIGNATURE 44 I �..►, °. .Y�Ge .r�a 9/®� DATE TOWN STATE ZIP INSPECTED BY TOWN DATE TELEPHONE NUMBER WHITE — TOWN PINK — CONTRACTOR YELLOW — CONSULTING ENGINEER / DEVELOPER r l Will AMR& Am 500 ■■aI■�irr■a . �/ .. . ._.,..__ ■ VMS-mild ■NOUNS ■■■ ■■■■r■ ■ ■ ■■11111011111111fo an No ■■ ■■■! I a to■■ M ■ ■ ■ ■■■■ ■■■III ■ ■■■■� ■■ ■ ■■■■■ ■ ■ 1■■I■1arv�r �■■■■ ■■■■ ■■■■■■■■■monism ON No ■ WE,* ON ■■■ ■■ ■ ■■ ■ ■sly� . ■ ■I�lI■ ■■■ ■■■■ ■1NONO �■■ �� ■....�■ ■■ ■ ■■■■■■■ o f• l/t t t• t• EMS 1 1 f f R D` APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR ' PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE ` SOUTH WINDSOR, CT FEE $60.0 0 Location of proposed work: 7 - Street No. /`aSsrlvi Lot# Street Name Premises owned by; , Name of rirm: �. Phone: _O ZX- Address.of Firm: ai'O6 TYPE OF WORK: Lay House Drain__Y� Repair House Drain . - LayMain . n ' Lay:Lateral for Commerdal iZstrlai Building of . acres - Connection will be made with K /►E SS�d� Existing Water SuPPIY: Public Water Well Proposed Start Date Z Estimafied time for completion ALL:WORK TO BE IN ACCORDANCE WITM-TOWN OF SOUTH WINDS ALL OSHA OR ST_REQUIREMENTS AND CONDITIONS ATTACHED TO THE RMT STANDARDS,, Permit Is to be issued to G pd. J/ gees License No. the holder of Drain Will be issued.a Only.holds of P-1, P-7 or W-9 licenses t PERMIT WILL EXPIRE THIRTY(30)1DAYS AFTER . DATE OF ISSUANCE. The undersigned Drain Layer.hereby agrees to all-and conditions set forth in the the terms Town Street Excavation Permit No tt and attached thereto Applicant has recelved and/or ConnDOT Permit No. -CBYD No. Signed. Licensed D Print Name• �eo Drain Layer Date:' Standard Forms\PermitS;WPLTCATION FOR DRAIN LAYERS PERMIT.doc