HomeMy WebLinkAboutDrain Layers Permit 36 Heritage Drive TOWN OF SOUTH WINDSOR INSPECTION REPORT
Perm; t ^Jo , r600 Contractor J & H SLATER CONST C^
Location 36 HER.T_TAGE DRIV- Address 75 -0P4V.FRCE 4qA`(
Type Work NLVJ SAN LAT SOUTH WINDSnR CT n6074
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TIM Insp Needed Timm �Ii�l� � � 141 PA
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Permi': No. 6600 i-own of South Windsor, CT
Permitr--Da-te--04-/_.25/ 1997 Drain Layer Perm-it.
Expiration Date 05/25/1997
Descr,ip: RECEIPT #473.1
Applicant t_ocat i on
Name J & H SLATER CONST GO Addr . J
Addr . 75 COMMERCE--WAY ' "Uwtrter, RSK KkLLCO
SOUTH WINDSOR CT 06G74 . :
Phone No. (860)52,8-5252
The Drain Layer assigned this permit has a yal°id license, issued by the
state and hereby agrees to ,al i the terms end oonditiobs set forth in the
attached 'Conditions ' . Al V woH,, shah "be ,in accorc#ante wth Iown of South
Windsor standards, a 1 i OSHA rAepu'i rement,s and the attached conditions.
Issued By -
Date Inspected / `7 Inspected ay �"����
` 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: Lot #
Street No. Street Name
Premises owned by: XfSIL
Name of Firm: Phone: 52-8-525�
Address of Firm: �� v
TYPE OF WORK:
Lay House Drain Repair House Drain ;
Lay Main Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with 6¢ AIC
Proposed Start Date - ' 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
Permit is to be issued to / � / _��5� the holder of Drain
layer's License No. 7677t1 7 . 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.
Signed: Print Name
Licensed Drain Layer
Date: --X- < '7
` TOWN OF SOUTH WINDSOR
SAPITARY SENM INSPECTION CHECKLIST
FUNCTION NO YES N/A DATE INSPECTED
1. Is Permit On Job Site
2 . Police Notified KID
3 . Safety Items In Place
a. Shoring, Trench Box, Ladder R D S 2
b. Hard Hats s Z
c. Pumps RD s'
4 . Proper Material
C1. Pipe
b. Pipe Bedding 2ra 3 �
C. Backfill sz
d. Warning Tape
e. Pipe Cap or Plug s �
f . Cleanouts
g. Fittings 62
h. Manhole s
i . Cover & Frame
5 . Existing Lateral Cap Removed 0
in Presence of Inspector
6 . Lateral probed and found �� S�z
to be clear
7 . Pavement Cut Properly )�
8 . Trench & Bedding OK s Z
9 . Joints Properly Done
SA
10 . Backfilling (12" Lifts)
& Compaction
11 . Manhole Inverts Built R� Z
12 . Subbase Material Placed
13 . Base Material Placed RD s 2
14 . Blacktop (Temp) w/Proper S/2
Grades & Slopes
15 . Pressure Test �� Z
16 . Mandrel Test ® S`2
17 . Installation agrees with plan
18 . As-Built plans recorded U s 2