HomeMy WebLinkAboutDrain Layers Permit 30 Leah Lane f!I
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 6695 Contractor- GERBER CONSTRUCTION CO
Location 0030 LEAH LANE Address 616 DART HILL ROAD
Type Work NEW SAN LAT VERNON CT 06066
�P"Orle No.". S60)875--6684
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Date Insp Needed Gate znsp _ 1._La _!7
Time Insp Needed _..-_._ _ - - -- Time Insp,•
Inspected By -- G :#1 +.�� _--�__
Work i n Progress -_5 �',1 �=s�.cCt _ Yrz � ._._._dcT_ ?�`'.--__ �� ......
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Input .��_`- �:E _._ Date
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Permit No. 6695 Town of South Windsor', CT .
Permit )ate 04/23/ 1 997 Drain Layer Permit
Exp i rat ion Date 015/23/ 1 9f0 j
Descrip :
Applicant Location
Name GERBER CONSTRUCTION CO Addr: ` 008G L,EAH LANE
Addr. 616 DART HILL ROAD r Owner =BGS" DEVELOPERS LLC
VERNON CT 0f3066
Phone No. ( 660)875-6684
The Drain Layer assignus this permftl,has a v id 7i"tense issued by the
state and hereby agrees to ai"I the terms and c6nd1tivns set forth in the
attached 'Conditions ' . All work shall be 'in accordance with l"own of South
Windsor standards , all OSHA" rerlu i rements .and the attached i::ond i t i ons,
Issued BY - rd Title .___%-���- ��= — - - ---- ---_ -
f /
747
�i'
Date Inspected --. - - - ---- -- Inspected By
At
TOWN OF SOUTH W139 SOR
4 uA L�/-� SANrl!ARY SERER INSPECTION CHECKLIST
FUNCTION NO YES N/A DATE INSPECTED
1. Is Permit On Job Site fio
Lo
2. Police Notified
3 . Safety Items In Place
a• Shoring, Trench Box, Ladder � J R
R
b• Hard Hats
c . Pumps
4 . Proper Material
a . Pipe ED
b. Pipe Redding
C. Backfill �� �D
d. Warning Tape E 9_
e. Pipe Cap or Plug �� 0
f • Cleanouts RQ
g. Fittings o
h. Manhole �� �-
i . Cover & Frame
5 . Existing Lateral Cap Removed r
in Presence of Inspector
6 . Lateral probed and found
to be clear
7 . Pavement Cut Properly D
8 . Trench & Bedding OR SQ—
9 . Joints Properly Done 9
10 . Backfilling (12" Lifts)
& Compaction
11 . Manhole Inverts Built V ��
12 . Subbase Material Placed (
13 . Base Material Placed I'
14 . Blacktop (Temp) w/Proper N-D RD
Grades & Slopes ''\\
15 . Pressure Test J �
16 . Mandrel Test RPD
17 . Installation agrees with plan RD
_- - --_. 1.8_.____As-Built plans recorded -
APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH WINDSOR
• PUBLIC WORKS DEPARTMENT
TOWN HALL
1540'SUIJ"AN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work:, D -e-. Lot #
Street Street Name
Premises owned by: ,l1/e:.e�G c
Name of Firm: �P�hoe:
Address of Firm: `' ,,. ,- L� d P
TYPE OF WORK.-
Lay House Drain ; Repair House Drain
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with 0/
Proposed Start Date '71-O y Estimated time for completion Z y` _f
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 � �,,.
�y� , the holder of Drain
layer's License No. 0012 ��v�yr-��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: `w ,,r^ Print Name
Licensed Drain Layer
Date: