HomeMy WebLinkAboutDrain Layers Permit 88 Nevers Road TORN OF SOUTH fiii OR
A SANITARY SEWER INSPECTION CHECKLIST
FUNCTION NO YES N/A DATE INSPECTED
1 . Is Permit On Job Site
2. Pollce Notified k
3 . Safety Items In Place
a. Shoring, Trench Box,(Lad eD
b. Hard Hats tr
C. Pumps
4 . Proper Material
a. Pipe D >r
b. Pipe Bedding R O r�
c. Backfill RD it
d. Warning Tape It
e. Pipe Cap or Plug _K °r
f . Cleanouts _So) If
g. Fittings
h. Manhole _ !r
i. Cover & Frame
5 . Existing Lateral Cap Removed
in Presence of Inspector
6 . Lateral probed and found
to be clear
7 . Pavement Cut Properly ® !I
8 . Trench & Bedding ORS 1r
9 . Joints Properly Done
10 . Backfilling (12" Lifts) I !!
& Compaction
11 . Manhole Inverts Built
12 . Subbase Material Placed
13 . Base Material Placed
14 . Blacktop (Temp) w/Proper ` 'r
Grades & Slopes
15 . Pressure Test
16 . Mandrel Test RA) '!
17 . Installation agrees with plan
18 . As-Built plans recorded
APPLICATION FOR:DRAIN LAYERS.PERMIT
TOWN OF SOUTH WINDSOR
PU13LiC WQRK$DEPARTMENT
TOWN HALL
1540 SULL[VANAVEIMUE
SOUTH WINDSOR, CT
FEE$25..00
Location of proposed work:' ,8 8` E i�� '� Lot #
Street No. Street Name
Premises owned by [22 41 Q C) C� R ou X
Name of Firm: u E CD j ti c Phone: a Q �i
Address of Firm: 3 o x �:�7: ���t �2 y c i
TYPE OF WORK:
Lay House Drain Repair House Dram ,
Lay Main T; Lay Lateral for Comrnercial/Industrial
Budding of / acres
Connection w.11 be made with
Proposed Start Date stimated time for completion A`
ALL WORK TO BE IN .ACCORDANCE WITH TOWN OF SOUTH WINDSOR
STANDARDS, ALL OSHA P-EQUIREMENTS AND CONDITIONS ATTACHED TO
THE PERMIT
Permit.is to be issued to _l')'I 1c.> �► u ` s(C. Cb �$, 4 . the holder of Drain
layer's License No. 0 5. Only holders of P;i, 0& W9 licenses will be
Issued a permit. Permit wi11 expire thirty (30) days after date of issuanceR 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 Per No. and/or ConnDOT Permit No.
Cl3 t� ,. g6s� QCv3'7
Signed: Print Name C., . e 1 /1
4
Licens Dr yer,
Date: 7 �/
` I
i
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. - 6538 Contractor COVEN CONilTRUGTIONr ,O.
Location 88 NEVERS RD. Address P.O. BOX 511
Type Work NEW 5AN LAT COVENTRY CT 06238
Prone No. (.860 )282-0526
Date Tnsp Needed _._._ L,. .. Date Inso __._ ..
-
Time Insp Needed Time Insp.
Inspected By
Work in Progress 6 l� /v / _ 71Y114
t
i
1r1pu,t,\;_ \.' � s� _.r Date
1
j
Permit No. 6538 town of South Windsor, CT j
Permit Date 12/19/1996 Prain Layer Permit
Expiration Date 01 / 18/ 1897
Descrip: '
App ! _i claret Loc;a ;i on
Name COVEN rpUNSTRltC` ION CO.. Addr., 88 NEVERS RD.
Addr. P.O. BOX 511 Owner GIROUX CONSTRUCTION
COVENTRY CT 06238
Phone No. (860)282-0526
`The Drain Layer assigned this: perms t has a va I'-i d license issued by the
state and hereby agrees to al-1 the terms and .conditions set forth in the
attached 'Conditions ' . A 1 -! work -stfa 1 1 be in, accordance with Town of South
Windsor standards, all OSHA requirements and the attached conditions.
Issued By ,� Title
[gate lnspec.i.e�c! i�.{act/.�� ._
I nspec;Led