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HomeMy WebLinkAboutDrain Layers Permit 31 Beechwood Lane - _ '\yyt -"T•[ .,e'er � #-• `P TOWN OF SOUTH WINDSOR DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL DRAIN LAYERS PERMIT fw 5981 / r , 19 ,3 Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform the work indicated below at . 3 5 Z /® , at premises owned by - Y whose address is4 and to. Lay House Drain, Repair House DrairV, Lay Main, Other for ;,,, occupancy or use, with Family Units, ith; acres. Type of SewaNe to be connected under this permit : SANITARY SEWAGE ( , INDUSTRIAL WASTES { ) , OR ( ) Connection will be made with Show sketch of /proposed N��r k or furnish two (2.) copies of separate drawings. 1 HA REQUIREM NTS MUST BE FOLLOWED SPECIAL CONDIT S ? 4 Desired -Stalrting Date r14j Estimated Time f14 or Com letion 04 Permi'i to be issued to e.r ��the holdef of Drain Layer's Lic nse N Permit will exptre thirty ('30) days after date of issuance. The undersigned Drain Layer her by agrees `- to all the terms and conditionsiset . forth in the permit 'and the. reverse side they f. Applicant has received Town Permit No. and/or CHD/Permit No. 241 Signed 4v� L censed Dr in Lamer The above named Drain Layer has a valid license issued by the State of Connecticut and has filed a satisfactory bond and insurance policy in the name of the Town of South Windsor: ng _S ring Dept. Date Permit Fee Paid $ L -,© Check Number Connection Charge Receipt No. Dated j /< 3 Issued by C i INSPECTION Date work started Date completed7` Sufficient notification re a ve' a '—r'— s a No Special Conditions —'- APPR D. Inspector Dafe TOWN OF SOUTH WINDSOR SANITARY SEWER INSPECTION ('SE=ST FUNCTION 35 U/ �NO YES N/A DATE INSPECTED 1. Is Permit On o Sit� _�� 7- 7 9� ,, .5 2 . Police Notified 3. Safety Items In Place a. Shoring, Trench Box, Ladder b. Hard Hats C. Pumps 4 . Proper Material a. Pipe b• Pipe Bedding _ C. Backfill d. Warning Tape e. Pipe Cap or Plug f. Cleanouts �i- g. Fittings h. Manhole i. Cover & Frame 5 . Existing Lateral Cap Removed 1/ in Presence of Inspector 6 . Lateral probed and found to be clear 7 . Pavement Cut Properly 8 . Trench & Bedding OR e/ 9 . Joints Properly Done e� 10 . Backfilling (12" Lifts) & Compaction 11. Manhole Inverts Built � 12. Subbase Material Placed 13. Base Material Placed 14 . Blacktop (Temp) w/Proper rf Grades & Slopes 15 . Pressure Test 16: Mandrel Test 17 . Installation agrees with plan 18 . As-Built plans recorded