HomeMy WebLinkAboutDrain Layers Permit 121 Overlook Road TM4f' r-7 SnJU-71 WTP,DSOR TN SPECTT-Pj P 7) RT
Permit. N,) . r= 1 _ tractor 1.,l. LEVA,;, : CO.
i ocat i on ,1 01 OVER1-01011 _- .? •
Ty;)e Wort t^! 7�A'. L A T 07a
n�n �� seed tb
Date T
x #
l ff
Work. r: Prooress
4� �ee � eA,` e 1
tNher� �✓as c�f; a �" a
r
t e- coh s � .� ,h ��� s�. I A-
4-`� off S 14C '�l lat C �� _Date G—r
i
Permi-t No. 6614 Town of South Windsor, CT
Permit Date 05/16/1997 Drain Layer Permit
Expiration Date 06/15/1997
Descrip:
Applicant
Location
Name H. W. LEVACK CO. Acr" Q121 OVERLOOK ROAD
� Addr. 49 MASCOLO ROAD `
rs. 00h SiMt#.� SCOTT A. & CLARK ELIZABET
SOUTH WINDSOR CT„06d ,4
Phone No. (860)528-0131
WE
The Drain La er as Y 9its � s a ...` .* i ense issued by the !
state and hereby agre�s c the . d T` i � set forth in the
attached Conditions ' , , I �k �
; ►"? ar with Town of South
Windsor stan and
al I"
H1 ched conditions. 3
Issued By
Date Inspects 6 p e
Tsbid' By
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: </N 0)4,yzl PA Lot #
Street No. Street Name
Premises owned by. SSG I :
Name of Firm: L .... Phone: 2-!9 �,]?,
Address of Firm: 4W-54 ;�
TYPE OF WORK: /
Lay House Drain Repair House Drain -
Lay Main - Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with Z,
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 toJyJ the holder of Drain
layer's License No. 7. Only holders of PI&5& 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
Lice d Drain Layer.
Date: "��
a ] O ver/oo4 . hr.
6/ TOWN OF SOUTH AIHDSOR
SANITARY SEWM INSPECTION CHLCKI.IST
FUNCTION NO YES N/A DATE INSPECTED
1 . Is Permit On Job Site
2 . Police Notified gD
3 . Safety Items In Place �� S/
a . Shoring, Trench Box, Ladder
b. Hard Hats
C. Pumps 6
4 . Proper Material
a . Pipe 5 aV
b. Pipe Bedding Sao
c. Backf ill RQ _ sao
d. Warning Tape o
e. Pipe Cap or Plug zQ
f . Cleanouts RD SZe
g. Fittings 6R D Sao
h. Manhole RD,^
i . Cover & Frame D sty
5 . Existing Lateral Cap Removed KD S z�
in Presence of Inspector
6 . Lateral probed and found /�6
to be clear
7 . Pavement Cut Properly
8 . Trench & Bedding OK
9 . Joints Properly Done
10 . Backfilling (12" Lifts )
& Compaction
11 . Manhole Inverts Built $b0
12 . Subbase Material Placed _ ate
13 . Base Material Placed
14 . Blacktop (Temp) w/Proper S��o
Grades & Slopes /
15 . Pressure Test
16 . Mandrel Test
17 . Installation agrees with plan a
18 . As-Built plans recorded S��D