HomeMy WebLinkAboutDrain Layers Permit 11 Porter Green j
[OWN OF SOUTH WINDSOR INSPECTION REPORT I
Permit No. 6651 Contractor JMJ CONSTRUCTION CO.
Location 0011 Porter Green Address 658 ELLINGTON ROAD
Type Work NEW SAN LAT SOULH WINDSOR CT 06074
Phone No. ( 860 )528-7889
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Date Insp Needed -Date Insp. _.♦__�� 1: ..r- ---
Time Insp Needed the r
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Inspected By
Work in Progress
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permit 119. 6155i town of youth Windsor, C:1
Permri t Gate 01/08/1997 Drain Layer Permit
Expiration Date 02/07/ 1997
Descr i p ; NEW 8ANI"1 Ak`r LA-f ERAI_
App I i caret LC)1„a-t, on
Name JMJ CONSTRUCTION CO. Addr . 0011 Part.er, Green
Addr. 658 .ELL.INGTON ROAD Owner- .C:L.ARK REAL`f`Y", INC.
SOUTH WINDSCR C1 ' 06074
Phone No. k86U)628-7889
The Drain Layer assigned this permit has a val-i d 'license issued by the
state and hereby agrees; to all the- terms- And conditions set forth in the
attached 'Conditions ' . All - work shall be in accordance with `!"own of South
Windsor standards, all OSHA requirements, and the attached conditions.
Issued By fL= --- _ Title ' ;`f' c ! 1'7 L fj Z -
J
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Date Inspected --- _ 1 _y7 Inspected by - --- --
TOWN OF SORTS WINDSOR
P�r`f SANITARY SEWER INSPECTION CHECKLIST
FUNCTION NO YES N/A DATE INSPECTED
1. Is Permit On Job Site
2 . Police Notified
3 . Safety Items In Place
a. Shoring, Trench Box, Ladder ►�q
b. Hard Hats t q
C. Pumps � y
4 . Proper Material
a Pipe ►/y
b. Pipe Bedding _C . Backfill
d. Warning Tape 1/17
e. Pipe Cap or Plug Rp i
f . Cleanouts SD
g. Fittings iRb 0.7
h. Manhole _Rj 1y
i. Cover & Framed 10 _
5 . Existing Lateral Cap Removed j1
in Presence of Inspector
6 . Lateral probed and found
to be clear
7 . Pavement Cut Properly _
8 . Trench & Bedding OK
9 . Joints Properly Done
10 . Backfilling (12" Lifts)
& Compaction
11. Manhole Inverts Built i19
12. Subbase Material Placed_ t�
13 . Base Material Placed _
14 . Blacktop (Temp) w/Proper
Grades & Slopes n'l
15. Pressure Testes 11q
16 . Mandrel Test ; I/?
17 . Installation agrees with plan _ 19
18. As-Built plans recorded �/`1
APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH VAMSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WIIVDSOR, CT
FEE$25.00
Location of proposed work: Lot #
Street No. Street Name
Premises owned by: s
Name of Firm: /h Phone: '24' > cf-�'b 2--
Address of Firm:
TYPE OF WORK:
La House Drain / Repair House Drain
y � _ ,
Lay Main Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with S U 3
Proposed Start Date.�stimated time for completion L�
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 V S LCO 571 the holder of Drain
layer's License No. � O y holders of Pl, P7 & W9 licenses will be
issued a permit. Permit will ex ire 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 ain Layer
Date: