HomeMy WebLinkAboutDrain Layers Permit 21 City View Terrace Permit No. 6546 Town of South Windsor-, CT
Permit Date 01/03/1997 Drain Layer Permit
Expiration Date 02/02/1997
Descrip: CONN.CHARUE PAID 12-30-96 ##4703
Applicant Location
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Name WILCOX CONSTRUCTION CO Add . 21 CIT'YVIEW TERRACE
Addr. 535 OLD STAFFORD ROAM Owner >8 & `M ENTERPRISES INC.
TOLLAND CT 06054
Phone No. (860)871--18:35
The Drain Layer assifined th s pe-rMit has a valid 1 -icense issued by the
state and hereby agrees tQ al: the terms and conditions set forth in the
attached 'Conditions ' . Al week shall be in accordance with lawn of South
Windsor standards all QSiA reOuirements, and the attached conditions.
Issued By -_ _ 'Title
Date Inspe t d --__ 11419 _7-7 Inspected 8Y
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. - 6546 Contractor WILCOX CONSTRUCTION CO
Location 21 CI-IYVIEW TERRACE Address 535 OLD STAFFORD ROAD
Type Worm NEW SAN LAT TOLL-AND CT 06084
Phone No. f 860 l81 1_..1-839
Date I nsp Needed __�1i `f .. Date I nap.
Time I nsp Needed -.-_ _ .__.. ..._ Time Insp.'
Inspected By ---
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Work in Progress
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Input \ Date
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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 Lot #
Street No. Street Name
Premises owned by: r`e��' ve,
Name of Firm: /4//Z62�E Phone: /
Address of Firm: ''
TYPE OF WORK: j
Lay House Drain Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Proposed Start Date/ 7stima ed time for completion . 6 '
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 `�`G .407 tt// the holder of Drain
layer's License No. Q'`1. Only holders of PI, gP& 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. ancVor ConnDOT Permit No.
Signed: Print Name ,
Licensed Drain Layer
Date: zz
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TORN OF SOUTH WINDSOR
SANITARY SEWER INSPECTION CHECKLIST
FUNCTION NO YES N/A DATE INSPECTED
1. Is Permit On Job Site Alf7
2 . Police Notified % y7
3. Safety Items In Place
a. Shoring, Trench Box, Ladder
b. Hard Hats -ail
c. Pumps
4. Proper Material
a. Pipe
b. Pipe Bedding
c . Backfill i?►)
d. Warning Tape n D
e. Pipe Cap or Plug
f . Cleanouts t�
g. Fittings t�
h. Manholes
i. Cover & Frame
5 . Existing Lateral Cap RemovedZ
in Presence of Inspector
6 . Lateral probed and found
to be clear
7 . Pavement Cut Properly
8 . Trench & Bedding OR �()
9 . Joints Properly Done
10 . Backf illing (12" Lifts)
& Compaction
11 . Manhole Inverts Built
12 . Subbase Material Placed RD
13 . Base Material Placed
14 . Blacktop (Temp) w/Proper
Grades & Slopes
15. Pressure Test
16 . Mandrel Test
17 . Installation agrees with plan
18. As-Built plans recorded kD