HomeMy WebLinkAbout2256 Marshfield Ln - Correspondence/Water and or Sewer - 02/16/2010No 011380
2/10/10 Called In
2/12/10 Requested for
BP
INSPECTION FRIDAY 1 P K
-Y
c
Sryn�\
�O
SANITARY SEWER SYSTEM
CONTACT
TOM/ASPEN HOMES
SERVICE ADDRESS 2256 MARSHFIELD LN PHONE 567-1029
OWNER ADDRESS
❑ SERVICE CALL ❑ WORK ORDER
REASON FOR CALL
❑ LOCATE (If Locate is for new service line construction read notes for inspection below)
Saddle Set
Stub Out Used
REASON FOR LOCATE
Reasonable effort has been made to accurately locate the center of Boxelder Sanitation District sewer lines sewerint The the cats
of mahk rigs rice address as
approxquest d a d the a have been on of the sewer (acccur to to w th n on ground surface 18 inith gches ireen naeither diirect on) location
Always use caution when excavating
is estimated to be
near any utility and expose pipes so that pipes are not damaged and pipe bedding disturbance is minimize
N
&,,O K TO BACKFILL Date z o BSD Initial Ar
NEW SERVICE INSTALLATION NSPECTION
NOTE
1 Connection to sanitary sewer collection system cannot be made until System Development Charge is paid to the District
le connector
2 contnectorsaddle
theset
collectorr lineincludes
Permittee or ay NOTtand under any circumstances tattempt tocollector
penetrate main collector linesor saddle 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
aterin4 tormittee mainconnecll tion and and backflide all lvaslon required iby the DistrictdewigFederal and Statservice line e OSHA equirials and brementsor for � andaappllca na er or his
and Plumbing Codes No excavation shoring dewatering or backflll 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 collectionystem due to improper connections grades bedding materials or placement or pipe material The
District will require correction of any improper connection through Its enforcement authonty— —
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 any liability for any deficiency or defect of service line materials or installation wnich is no
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 to 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 5-iv z s Pipe Bedding Material 4�' 'eut-
installlation Sabsfactory? Elder Valve Satisfactory 'K, Pipe Slope Adequate
Pipe Bedding Satisfactory? �_ Locator Wire Property Placed? = 4 Back ill Sabsfactory) �C
Inspected by
Date 7 �
for Boxelder anitation Distract
` �O K TO ISSUE CERTIFICATE OF OCCUPANCY Date . BSD Initial iS/it-
By signing I acknowledge having read and understood the forgoing and acknowl dge receipt of a copy of this form
Received by Date
3201 E Mulberry Unit Q P O Box 1518 Fort Collins Colorado 80522
ni— in"70% neQ ntinn ❑ v ram aast min