HomeMy WebLinkAboutDrain Layers Permit 3 Chapman Circle I
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Permit No. 6560 Town of South Windsor, CT
Permit 'Date 01/23/1997 Drain Layer Permit
Expiration Date 02/2?/ 1997
Descrip:
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App i i cant t_ocaY,i on
Name MICHAEL WILCOX Ardr.
3 CIIAPmAN CIF2CL1,
Addr. EAGLE EARTHWORK SERV .
C�"�er`MANPJAR';1N0 BUILDERS
101 N MOUNTAIN ROAD:
CANTON CT 06019 I
Phone No. (860)693-2027
The Drain Layer assigned 'th'is ,permit has a ual'rd Ticense issued by the
state and hereby agrees to,: i" the teems rtd condi,6 set forth in the
attached 'Conditions ' Ali "Work �shai'l- be #n accordanoe with Town of South
Windsor standards, all OSHA;° requirements, and ,the attached conditions.
Issued By
Date InspectedInspected By
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 6560 Contractor MICHAEL WILCOX
Location Address EAGLE EARTHWORK SERV .
Type Work NEW SAN LAT 101 N MOUNTAIN ROAD
CANTON CT 06019 i
Phone °�;No. „ (860)693-2027
Date Insp Needed 1 'UO , t In<;ri.' "
) l3D
Time Insp Needed - - -- --- -- Time Insp - -- --- - -
Inspected By
Work in Progress byei5_
--- Pet - -----6e �f'� __ � ac `1 - -
Input Date
z - 2�
APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work: /' tv �i �' Lot # 6
Street No. Street Name
Premises owned by: Anylitao, XudlLvs'
Name of Firm: 0 eV 5 Phone: �lt+-74&0
Address of Firm: ( aEd
TYPE OF WORK.
Lay House Drain Repair House Drain ;
Lay Main ; Lay Lateral for CommerciaVIndus trial
Building of acres
Connection will be made with Pye s -3 J5
Proposed Start Date C-Z Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR
STANDARDS, ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO
THE PERMIT
l
Permit is to be issued to the holder of Drain
layer's License No. 277141 Only holders of P1, 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
in the permit and attached thereto. Applicant has received Town Street
Excavation Permit No. and/or ConnDOT Permit No.
c
Signed: Print Name r blael VIC0�(
Licensed Drain Layer
Date:
3 aprr�avl G i r /t TOWN OF SOUTH WINDSOR
SANITARY SEWER INSPECTION CHECKLIST
FUNCTION NO YES N/A DATE INSPECTED
1. Is Permit On Job Site L4 1
2. Police Notified
3 . Safety Items In Place
a. Shoring, Trench Box, Ladder ft
b. Hard Hats _ 1 2
c. Pumps -day-
4 . Proper Material 2
a. Pipe tag
b. Pipe Bedding
c. Backf ill
d. Warning Tape Rp A
e. Pipe Cap or Plug KD
f. Cleanouts _ qD 2
g. Fittings (�
h. Manhole BIZ >
i. Cover & Frame RD oa
5 . Existing Lateral Cap Removed
in Presence of Inspector
6 . Lateral probed and found
to be clear
7 . Pavement Cut Properly RID ��ay
8 . Trench & Bedding OK IDL
9 . Joints Properly Done Ro_ '�z9
10 . Backfilling (12" Lifts) PQ ��zY
& Compaction
11. Manhole Inverts Built
12. Subbase Material Placed
13 . Base Material Placed
14. Blacktop (Temp) w/Proper
Grades & Slopes
15 . Pressure Test
/).y
16 . Mandrel Test ;D �� y
17 . Installation agrees with plan R D 'ley
18 . As-Built plans recorded