HomeMy WebLinkAbout1103 Bateleur Ln - Correspondence/Water and or Sewer - 05/04/2006r rye `•_.
5-2-t)6
Called In O C�
m
CJ
5-4-06 Requested for
INSPECTION PYNT"'•DUE-
4Z/7�
�F9
FO
SANITARY SEWER SYSTEM
OWNER CONTACT
SERVICE ADDRESS 1103 BATELEUR LN
OWNER ADDRESS
AI
�j2 008118
Saddle Set
Stub Out Used
970-566-5040 ROGER @ DIRT 1 EXCAV.
PHONE 970-566-5040
❑ SERVICE CALL ❑ WORK ORDER
REASON FOR CALL_
LOCATE (If Locate is for new service line construction, read notes for.inspection below)
REASON FOR LOCATE:
Reasonable effort has been made to accurately locate the center of Boxelder Sanitation District sewer lines in the vicinity
of the service address as requested and these have been marked on ground surface with green paint. The sewer location
markings represent approximate horizontal location of the sewer (accurate to within 18 inches in either direction). Depth
is estimated to be: . Always use caution when excavating
near any utility, and expose pipes so tat pipes are not damaged and pipe bedding disturbance is minimized.
N
® O.K.TO BACKFILL Date 6-V-00 BSD Initial /-//
E..0 NEW SERVICE INSTALLATION INSPECTION
NOTE:
1. Connection to sanitary sewer collection system cannot be made until System Development Charge is paid to the District;
2. District saddle set charge includes labor, equipment, and tap saddle connector to drill the collector line and fasten the saddle
connector to the collector line. Permittee may NOT, under any circumstances, attempt to penetrate main collector lines or
, manholes without the consent of the BSD Construction Supervisor;
3. Locator wire is required for burial along the service line for future locating of the line;
4. Permittee shall provide all excavation, shoring, dewatering, service line materials and labor for installation of service line
to main connection, and backfill as required by the District, Federal and State OSHA requirements, and applicable Building
and Plumbing Codes. No excavation, shoring, dewatering, or backfill work will be done by the District, and the Manager or his
agent will require any additional excavation, shoring, or dewatering of the excavated space that in his judgement alone is necessary
before adequate inspection may be accomplished and approval of the service line installation is granted;
5. The District requires that all service lines be installed such that future use of the service line will not contribute inflow or infiltration
of groundwater to the collection system due to improper connections, grades, bedding materials or placement, or pipe material. The
District will require correction of any improper connection through its enforcement authority;
6. Permittee shall notify the District at least 48 hours prior to when the service line is expected to be installed and ready for inspection
and connection;
7. The District shall not be subject to anyliability for any deficiency or defect of service line materials or installation which is'not
discovered by inspection nor shall owner or permittee be absolved from liability for any deficiency or defect of service line materials
or installation and any resulting damage or from responsibility to correct such deficiency or defect. The District does not assume any
obligation nor acquire any liability for personal injury'ta any party or damage to the connecting property or any portion thereof caused
by or resulting from any such connection to the wastewater collection and treatment system;
8. The District requires payment of a $50.00 construction inspection charge for this inspection.
Type of Pipe: yrPdG Pipe Bedding Material:
Installation Satisfactory? ,/ Elder Valve Satisfactory: t� Pipe Slope Adequate? ✓
Pipe Bedding Satisfactory? Locator Wire Properly Placed? Backfill Satisfactory?
Zo.
ed by: "����' • Datefor,Boxelder anitation District
K.TO ISSUE CERTIFICATE OF OCCUPANCY Date (1Z 1UL, BSD Initial A4JJ-
By signing, I acknowledge having read and understood the forgoing and acknowledge receipt of a copy of this form.
Received by: Date
3201 E. Mulberry, Unit Q - P.O. Box 1518 - Fort Collins, Colorado 80522
Phone (970) 498-0604 - Fax (970) 498-0701