HomeMy WebLinkAboutDrain Layers Permit 040 Austin Circle Permit No. 6544 Town of South Windsor', CT
Permit Date 12/30/ 1996 Drain Layer Permit
Expiration Date 01 /29/1997
Descrip: LOT 86 SAN. CONNECTION
Applicant Location
Name JMJ CONSTRUCTION CO. Addr. .0040�`�kust�fin Circle
Addr . 658 ELLINGTON ROAD Owner CLARK1_AV tL -Yv, INC.
SOUTH WINDSOR CT �306074 ,
Phone No.
The Drain Layer assigned thiseerm t has a .valid ) i`cense ,issued by the
state and hereby aq(re&9=`td all,3t . 4r'mjs--:`a d �6nd'itfdrvw setf,`torch in the
attached 'Conditioafs ' . 411 ..work 'shall de in accordance with Town. ot South
Windsor t nda�r�d �l i &S+Hk'*e4`u i r�l pit and -the ,Attached coHd.'i t i'ans.
Issued By �L= ' -- _ Title � c? e -
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Date Inspected _ . --- _ Inspected By ---
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TOWN OF SOUTH WINDSOR INSPECTION REPORI
li
Perm t No. 6544 Contractor JMJ CONSTRUCTION CO.
Location 0040 Austin Circle Address 658 ELLINGTON ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
Phone Nt . (860 )528--7889
Date i nsp Needed Date
,fir- ��•'�" "
Time I n s p Needed rime Insp.
__.-_____ _,__ __._ -------.- -- .-------_----
Inspected By - -- - - -
i !
Work in Progress — ic -- -- - 1---_ Y �— __ ----
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TOWN OF SOUTH WINDSOR
SANITARY SEWER INSPECTION CHECKLIST
FUNCTION NO YES N/A DATE INSPECTED
1. Is Permit On Job Site J A
2 . Police Notified rA ID
3 . Safety Items In Place
a. Shoring, Trench Box, Ladder /14J/17
b. Hard Hats j 7
c. pumps
4 . Proper Material
a. Pipe
b. Pipe Bedding
c. Backfill _
d. Warning Tape
e. Pipe Cap or Plug
f • Cleanouts T
g. Fittings _
r�
h. Manhole
i. Cover & Framed �
5 . Existing Lateral Cap Removed
in Presence of Inspector _
6 . Lateral probed and found
to be clear
7 . Pavement Cut Properly XCL ,
8 . Trench & Bedding OR ILI ®�
9 . Joints Properly Done 6D
10 . Backfilling (12" Lifts)
& Compaction
11. Manhole Inverts Built V
12 . Subbase Material Placed 90
13 . Base Material Placed
14 . Blacktop (Temp) w/Proper
Grades & Slopes
15 . Pressure Test ( /i
16 . Mandrel Test i>
17 . Installation agrees with plan 1�
18. As-Built plans recorded
5A er �C,x
X
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APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
I540 SULLIVAN A
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work aO l /,,I Lot #
Street No. Street Name
Premises owned by: 7J7 1!� n
54
Name of Firm: Phone: _� 2 C 9
Address of Firm:
TYPE OF WORK:
Lay House Drain Repair House Drain
Lay Main Lay Lateral for Commerciai/Industra
Building of acres
Connection will be made with
Proposed Start Date Z �-Estimated time for completions --
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 t0 f�
SQ the holder of Drain
layer's License No. Only hol ers 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
An the permit and attached thereto. Applicant has received Town Street
.Excavation Permit No. and/or ConnDOT Permit No.
Signed: / Print Name-JC2 ► .�CP CdQU
Licens Dr Layer
Date 30