HomeMy WebLinkAboutDrain Layers Permit 48 Heritage Drive 'TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 6599 Contractor J & H SLATER CONST CO �
Location 48 HERITAGE DRIVE Address 75 COMMERCE WAY
Type Work: NEW SAN LAT SOUTH WINDSOR CT 06074 ,
Phone, No.,(860 )526- 5252
Date Insp Needed �_ Date
Time Insp Needed ---
Time Ir"Fsp
Inspected By --
Wort; in Progress _ _,--
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Input `� -`<r . . _ __ Date "t- � a"1 ---..
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Permit No. 6599 t'own of south Windsor, CT
Permit Date 04/25/ 1997 Drain Layer Permit
Expiration Date 05/25/ 1997
Desrr ip: RFCFIITT #4736
Applicant Location
Name J & H SLATER CONS'T CO Addr • � � f
Addr. 75 COMMERCE WAY Civ�raer R ' K._.
SOUTH WINDSOR CT ,"06074 "
Phone No. ( 860)528-5262
The Drain Layer 1 t-ense issued key the
state and hereby agre4s "tc� ' 411 the t�rC�arr . "and c0r�tl3lta on,s set forth in the
attached ' Conditions ' Ala 1,`f CT�,l. ,3F a ! :i.h ao r'dance with Town o South
Windsor standards , a j I 0SHA ': r bqu i reorients,, and :thk" att€ ched conditions .
Issued By : Tole -
Date Inspected ___---- - 'S� f- Inspected By %<%r - ✓__- --, � __.__---
I
i
�8 #ehr',(9e
T0WN OF SOUTH W=SOR
SAS EARY SEWER INSPECTION CHECKLIST
FUNCTION NO YES N/A DATE INSPECTED
1 . Is Permit On Job Site
2 . Police Notified
�r
3 . Safety Items In Place R�
a . Shoring, Trench Box, Ladder
b. Hard Hats RD
c . Pumps it
4 . Proper Material
a . Pipe Ir
b. Pipe Bedding RD �r
c. Backf ill 9D
d. Warning Tape AD /r
e. Pipe Cap or Plugi�
f . Cleanouts D
g. Fittings
h. Manhole it
i . Cover & Frame �_ • _77—
5 . Existing Lateral Cap Removed 8 D
in Presence of Inspector
6 . Lateral probed and found D /J
to be clear
7 . Pavement Cut Properly O\U —L
8 . Trench & Bedding OR RD
9 . Joints Properly Done
10 . Backfilling (12" Lifts) AD
& Compaction
11 . Manhole Inverts Built 9 b
12 . Subbase Material Placed _ED
13 . Base Material Placed v /r
14 . Blacktop (Temp) w/Proper
Grades & Slopes
15 . Pressure Test OIL 0�
16 . Mandrel Test
17 . Installation agrees with plan 9D
18 . As-Built plans recorded /!
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: A&LA E Lot #
Street No. Street Name
Premises owned by�- -5
Name of Firm: tlir' Phone:
Address of Firm: 7,5-
TYPE OF WORK:
Lay House Drain Repair House Drain ;
Lay Main Lay Lateral for Commercial/Industrial
Building of acres
u
Connection will be made with / j��
Proposed Start Date-11 -0' 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 � 6�' �/ � �tl/` the holder of Drain
layer's License No. 06 7;�Vlq . 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. rEJ and/or ConnDOT Permit No.
Signed: Print Name
Licensed Drain Layer
Date: ---11 -zs-�17