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HomeMy WebLinkAboutDrain Layers Permit 36 Vincent Circle TOWN OF SOUTHkWINDSOR INSPECTION REPORT Perrfi o. 6619 Contractor JMJ CONSTRUCTION CO,. Location 0036 VINCENT CIRCLE Address 658 ELLINGTON ROAD Type Work NEW SAN LAT «.. SOUTH WINDSOR CT 06074 � Phop Flo. (860)528-7889 Date Insp Needed lam' Ca X`. Ins0, S Sol q 7 ---- F � Time Insp Needed Inspected By • = a � Work in Progress 74k` # e y,, e S t { Inp � Date rP( rmit No. 6619 Town of South Windsor, CT rmit Date 05/22/1997 Drain Layer Permit piration Date 06/21/1997 jDescrip: C Applicant ��<..� Location Name JMJ CONSTRUCTION CO ' �ti� �: �06 VINCENT CIRCLE fAddr. 658 ELLINGTON ROAD � A= RHILL REALTY INC fj SOUTH WINDSOR CT 3r4, ` V' I Rhone No. (860 )528-7889 �` - = f The Drain Layer astfgh rt- i sr as i�fd_� icense issued by the state and hereby agree t nd Q1° 1t*b!lrs set forth in the attached 'Conditions' s Al &wt t"k Tvv k} n ad qi c ahy et with Town of South f Windsor standards, alb O d the-attached conditions. Issued By PGk-r DD/ '- 4 � if �© R � 4� Date Inspected 7 � 41speotet .B-y _ e90 7 D. TORN OF SORTS F OR SANIZAR SEWM INSPECTION CHECKLIST FUNCTION NO YES N/A DATE INSPECTED 1. Is Permit On Job Site Pia 2 . Police Notified 3 . Safety Items In Place I� a. Shoring, Trench Box, Ladder KD b. Hard Hats C . Pumps _ >i 4 . Proper Material a . Pipe J/ b. Pipe Bedding 9 c. Backf ill Rh d. Warning Tape e. Pipe Cap or Plug ) f . Cleanouts g. Fittings h. Manhole i . Cover & Frame 5 . Existing Lateral Cap Removed It in Presence of Inspector 6 . Lateral probed and found to be clear 7 . Pavement Cut Properly 8 . Trench & Bedding OK RD 9 . Joints Properly Done 10 . Backfilling (12" Lifts) _ r_V & Compaction 11 . Manhole Inverts Built 12. Subbase Material Placed OW 13 . Base Material Placed 14 . Blacktop (Temp) w/Proper Grades & Slopes 15. Pressure Test17 �V 16 . Mandrel Test RD RD 17 . Installation agrees with plan 0 RD 18 . As-Built plans recorded aP � ( APPLICAVION FOR DRAIN LAYERS PERMIT TTQQWN OF SOUTH WINDSOR v PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE$25.00 Location of proposed work: .3 V l'1 j Lot # Street No. Street Name Premises owned by: _ Ta_La u"zf� S Name of Firm: Phone: r131, Address of Firm: (0 ' TYPE OF WORK: Lay House'Dra Repair House Drain Lay Main ; Lay Lateral.f or Commercial/Industrial Building of acres Connection will be made with 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 to 30 h o the holder of Drain layer's_License No. 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. andVor ConnDOT Permit No. Signed: QjjA, Print Name V, U� LicenAWd Dr i Layer Date: ^��