HomeMy WebLinkAboutDrain Layers Permit 15 Vincent Circle Permit' No. 6b34
1 Permit Date 12/ jo/ 19961-own Of South Windsor, C. f
Expiration Date 01/09/ 1997 brain Layer, Permit
Descrip:
Applicant Location
Name 1MJ CONSTRUCTION CO. Aodr. 00 1 15 VINCENT CIRCLE
Addr. 668 ELLINGTON ROAD Owner DART HILL REALTY INC
SOUTH WINDSOR CT 06074
Phone No. ( 860 )528-7689
The Drain Layer assigned this Permit has a valid license issued by the
state and hereby agree a to- all the terms and conditions Set forth in the
attached ' Conditions . All-w- ork shall -be in accor-dance with Town of South
Windsor, standards, all OSHA r-equirements, and the attached conditions.
Issued By
r T i t I e
Date Inspkct'�d
Inspected B
y
1GWN 01- .',S0ujH WiNDSOR 1fjopt-G-I'10N HE-PoR'l,
Permit No. 6534 Contractor JM,j CONSTRUCTION Co.
Location 0015 -VINCENI- CIRCLE Address 658 ELLINGTON ROAD
Type, Work NEW SAN LAT SOU WINDSOR CT 06074
PhOne NO. (1860 )528-7889
Date Insp Needed jzbol�
'-Date Insp._
Time Insp Needed
------ --- -- Time Insp.
Inspected By
Nork in Progress
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APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work: Uih C zf4z G,�%G�� Lot # 7i
_ Street No. Street Name
Premises owned bye
Name of Firm: Phone:
Address of Firm: S-$
TYPE OF WORK:
Lay House Drain Repair House Drain ;
Lay Main ; Lay Lateral for Commercial/Industrial .
Building of acres
Connection will be made with f
Proposed Start DategZ A�Estimated time for completion to
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 5c) cA S CD the holder of Drain
layer's License No. 2-&'YT30 Only h lders of P1, P7 86 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 5 CAY) J q
Lit
ed ain Layer
Date:
r TOWN OF SOUTH WINDSOR
0M �e-- SANITARY SEWER INSPECTION CHECKLIST
FUNCTION V,h can Cr�^c l�' NO YES N/A DATE INSPECTED
1. Is Permit On Job Site
2 . Police Notified ✓ 11
3. Safety Items In Place
a. Shoring, Trench Box, tea,=«=
b. Hard Hats rr
C. Pumps rr
4. Proper Material
a. Pipe L ►r
b. Pipe Bedding
c. Backf ill �
d. Warning Tape
e. Pipe Cap or Plug
f . Cleanouts
g. Fittings
h. Manhole rr
i . Cover & Frame
5 . Existing Lateral Cap Removed _� Ir
in Presence of Inspector
6 . Lateral probed and found
to be clear rr
7 . Pavement Cut Properly 1 �L
8 . Trench & Bedding OK
9 . Joints Properly Done f/
10 . Backfilling (12" Lifts)
& Compaction
11 . Manhole Inverts Built jl
12 . Subbase Material Placed z —L
13 . Base Material Placed fi- fr
14 . Blacktop (Temp) w/Proper
Grades & Slopes
15 . Pressure Test
16 . Mandrel Test
17 . Installation agrees with plan (/
18. As-Built plans recorded