HomeMy WebLinkAbout2462 Thoreau Dr - Correspondence/Water and or Sewer - 01/22/2007`'v e
1/10/07 Called In Q (,
3/12/07 Requested for V 1
5PL THURSDAY 1/11
PLEASE,
N! 008701
Sgo/eq
Saddle Set
' Stub Out Used
SANITARY SEWER SYSTEM
OWNER _ CONTACT IIEVIN _[ J3J EXCAVATION
SERVICE ADDRESS .,..2462 THOREAU DR.
OWNER ADDRESS _ _..__ PHONE _, _539-2352
❑ SERVICE CALL CI WORN; ORDER
REASON FOR CALL:
0 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 ofBpttelder Sanitation District sewer lines in the vicinity
of the service address as requested and these have been marked an ground surface with green paint. The sewer location
markings represent approximate horizorttai location of the sewer (accurate to within is inches in either direction). Depth
is estimated to be Always use caution when excavating
near any utility, and expose pipes 6o thdt pipes are not damaged and pipe bedding disturbance In minimized.
❑ OXTO BACKFILL Date____,-......._.__ SSD Initial
® NEW SERVICE INSTALLATION INSPECTION
NOTE:
1. Connection to sanitary sower collection system cannot be made until System Development Charge Is paid to the District;
2. District saddle set charge includes labor, equipment, and lap saddle connector to drill the collector Tina and fasten the saddle
connector to Ina collector line. Permittae may NpT, under any cireumslahees, attempt b par noole main collector gnae or
manholes without the consent of the aso construction supervisor,
3. Locator wire Is required for burial along the service line for future locating of the line;
4. Parmittee shall provide all excavation, shooing, dewatering, service line metarials and labor for Installation of service line
to main connection, and backBa as required by the District, Faders) and Stab OSHA requirements, and applicable Building
and Plumbing Codes, No excavation, shoring, dewatering, or backfill work will be done by the Dletrlot, and the Manager or his
agent will require any additional excavatiun, shoring, or dawatering of the eXcsvated space that in hie judgement alone is necessary
before adequate Inspection may be Accomplished and approval of the service line installation is granted;
5. The District requires that at sarvtca vines be Installed such that future use of the samos line will not contribute Inflow or infiltration
of groundwater tb the collection system due to improper connections, grades, bedding materials or placement, or pipe material. The
District w111 rmqulre correction of any improper connection through Its enforcement authority;
a. PermlOee shall notify the District at least 48 hours prior to when the service fine is expected to be installed and ready for inspection
and connection;
7. The District shall not be subject to any liability for any dafirlency or detect of eervlcs line materials or installation which Is not
discovered by Inspection nor Shall owner of pennitim be absolved from liability for any deficiency or defect of service line materials
Of installation and any resulting damage or from responsibility to correct such deficiency or dalect. The District does not assume any
obligation nor acquire any liability for personal Injury to any party or damage to the oonnectbrg property or any portion thereof caused
by or resulting from any such connection to the wastewater collection and treatment system;
e. The District requires payment of a $50.00 construction Inspection charge for this Inspection.
Type d Pipet Plpe Bed ft Mebflatt SmGrac�s'
tltste WOO Sr ory7 aC ElderWw SetlsfecWy: cC. Pipe Slops Adequate? hC
Pipe Bedding Sadaotecf V _ C- Ldator Wits PfopwlY Pleood? BgckpR py? 9G
Inspected blr, . _ 1x _4 — ...._ _ Date? 7
for Roxelder Ser,ftetlon District
fRL_PXTO ISSUE CERTIFICATE OF OCCUPANCY Date a .• BSD Initial
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 c:otins, Colorado 8OS22
Phone (970) 498-0604 • Fax (970) 498-0701
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