HomeMy WebLinkAboutDrain Layers Permit 47 Hitchcock Way a
. ~ TOWN OF SOUTH WJINDSOR INSPECTION REPORT
Permit No . 65454 Contractor MICHAEL WILCOX
Location 47 H•ITCHCOCK WAY" Address EAGLE EARTHWORK SERV .
Type Work NEW SAN LAT 101 N MOUNTAIN ROAD
CANTON CT 06019
Phone No ( 860)693-2027
Date Insp Needed Z D. t
r 4te' Ins
Time Insp Needed f'o a"0 f Time sp ?_ / ,1
Inspected 8y
LI
utj� ----
J/r e
'� --
Input - ` �i��-- Date --_--_—
Permit No. 6564 Town of South Windsor , CT
Permit Date 02/04/1997 Drain Layer Permit
Expiration Date 03/06/ 1997
Desc,rip: 47 HITCHCOCK WAY LOT 13 AVERY MEADOW
Applicant location
Name MICHAEL WILCOX Addr. 47 HITCHCOCK WAY
Addr. EAGLE EARTHWORK SERVr;1�ACNARItJO BUILDERS
101 N MOUNTAIN ROAD:
CANTONCT 060 9
Phone No. ( 860)693-2027
I
The Drain Layer assigned' this permit ;hAs a valid license issued by the
state and hereby agrees to'a' `I the e i end c6 iticns set forth in the
attached 'Conditions ' . `AI 1 ,'*wk 'shall : ,be- in acccar,'dance with Town of South
Windsor- standards, a] 1 OBFiA r�aqu rem d *®nts, ane. attached Cond i t.i ons .
} p ,
4
Issued 8 y�1 `i 1 i � r - _ -�_ - - -----—----
BY
Date Inspected l �/tZ _ I sp�cto t ��-
�r� —
TOWN OF SOUTH WINDSOR
RANTTARY SEWER INSPECTION CHECKLIST
FUNCTION NO YES N/A DATE INSPECTED
1 . Is Permit On Job Site
2 . Police Notified CD
3 . Safety Items In Place 2 d
a. Shoring, Trench Box, Ladder n D
b. Hard Hats a�
c. Pumps
4 . Proper Material
a. Pipe KD _;1//
b. Pipe Bedding 90 a �
C. Backfill , a 4
d. Warning Tape K yE'71e. Pipe Cap or Plugz
f . Cleanouts :2 6
g. Fittings t1D z
h. Manhole
i . Cover & Frame ��
5 . Existing Lateral Cap Removed
in Presence of Inspector
6 . Lateral probed and found
to be clear
7 . Pavement Cut Properly rQ
8 . Trench & Bedding OR QD
9 . Joints Properly Done 9D
10 . Backfilling (12" Lifts) 9D AA
& Compaction /
11 . Manhole Inverts Built _
12 . Subbase Material Placed 6
13 . Base Material Placed
14 . Blacktop (Temp) w/Proper °`(6
Grades & Slopes
15 . Pressure Test
16 . Mandrel Test pD
17 . Installation agrees with plan R-0 1A
18 . As-Built plans recorded ro
APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVANAVENUE
SOUTH WIIITDSOR, CT
FEE$25.00
Location of proposed work: 17 Lot # l�
M Street No. Street Name
Premises owned by: of /orgel�
Name of Firm: p�s Phone:
Address of Firm: -fl daklaite(
TYPE OF WORK.,
Lay House Drain Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with VC
r
Proposed Start Date 2 - S Estimated time for completion 2 5
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 UCH ,
/��
�' ( yl!dcbb the holder of Drain
layer's License No. 27P1/6 --. Only holders of PI, 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: W(izLPrint Name G�e2e(
Licensed Drain Layer
Date: 2 -�- �' 7