HomeMy WebLinkAboutDrain Layers Permit 23 City View Terrace �.•' TOWN OF SOUTH WINDSOR ,INSPECTION REPORT
Permit No. 6601 Contractor WILCOX CONSTRUCTION CO
Location 23 CITYVIEW TERRACE Address 535 OLD STAFFORD ROAD
Type Work NEW SAN LAT TOLLAND CT 06084
Phone' No. l`-8E 0 )87 1 - 839
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Date Ins Neededa" date' ins 111
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Time Insp Needed _2 �'% 7
- - Ti Insp, _ -
Inspected By
Work in Progress
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�.^. Ih ut �-�ctC��'�=- Date �`� {a ! (i
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'ermit No. 6601 Town of South Windsor, CT
)ermi,t Date 04/29/ 1997 Dr zi i n Layer Permit
:xpiration Date 05/29/1997
)escrip: UNIT 13 COLLINS CROSSING
Applicant Location
Jame WILCOX CONSTRUCTION CO Addr. `23 CITYVIEW TERRACE
kddr . 535 OLD STAFFORD ROAD Owner 8 & M ENTERPRISES
} E f
TOLLAND CT 06084'. ;
)hone No. (860 )871-1839
s'
The Drain Layer assigned this permit has a valid license issued by the
state and hereby agrees to-, a1.1 `the terms ,and d6hditi6rvt set forth in the
attached 'Conditions ' , Ali work shal1 be in accor,,ctahoe� with Town of South
Windsor standards, att OSHA rega cements, and the attached conditions.
Issued By "/� _ -•- =.,t. ; Title er eel-
)ate Inspected _,.. �_ Inspected By
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 P r 0
Posed work: ,Z , Lot #
Street No. Street Name
Premises owned by:
Name of Firm: l.Z--t�cfc;r Phone:
Address of Firm:
TYPE OF WORK:
Lay House Drain Repair House Drain ;
Lay Main Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Proposed Start Date Yl/4stimated time for completion
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
5-4-the holder of Drain
layer's License No. c/d 2/e ,? Only holders of P1, P & 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.
Signed: _ Print Name
Licensed Drain Layer
Date: a
3 TOWN OF SODTH WIPDSOR
SMfrMRY SEWER INSPECTION CHECKLIST
FUNCTION NO YES N/A DATE INSPECTED
1. Is Permit On Job Site
2 . Police Notified
3 . Safety Items In Place
a. Shoring, Trench Box, adder
b. Hard Hats
C . Pumps
4 . Proper Material
a . Pipe r D
b. Pipe Bedding -9
C. Backfill
d. Warning Tape �� y
e. Pipe Cap or Plug y a
f . Cleanouts 7D__ y �
g. Fittings
h. Manhole Rb q
i. Cover & Frame rev y
5 . Existing Lateral Cap Removed Rl) y y
in Presence of Inspector
6 . Lateral probed and found
to be clear y a-
7 . Pavement Cut Properly i�(� ay
8 . Trench & Bedding OK
9 . Joints Properly Done RI) yay
10 . Backfilling (12" Lifts )
& Compaction
11 . Manhole Inverts Built R D �9 zy
12 . Subbase Material Placed !R � w Z
13 . Base Material Placed �.� W �9
14 . Blacktop (Temp) w/Proper
Grades & Slopes
15 . Pressure Test L� a�
16 . Mandrel Test
17 . Installation agrees with plan
18 . As-Built plans recorded ) y a