HomeMy WebLinkAboutDrain Layers Permit 1359 Main Street 800043 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 04/17/08 GIS
ID: 54901359
MUMSAPPLICA TI ON
200 80 04 81
y> FEE:
25
.00 0
�RATI O ND h° DA
TE: 04/17/09
APPLICAN
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ONNAME: JAC UES CONSTRUCT"'
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ADDRESS: .
II STREET
67 RIDGE ROAD ��_..: :`}"�
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SCRIPTION:
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PPLICANT AGREES TO FURNISH THE T3, 0 .S [3: HpRy' € 1 Q $ D REQUIRED AND TO THE TOWN OF SOUTH WINDSOR FOR ANYYPES S' .C ': ` ` FIP{; F Q REIMBURSE
R 1AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE Al?PT IN�'.I " 1fAFIXg'Aj`WZ1 L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SC7 Hs1 $R?:SSTRF I' iI`:PERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
4/17/20081:54PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: :- G C ' ltiP.
LOCATION:_ I ����
TYPE OF WORK: -oa, ct
DATE INSP NEEDED: DATE INSP: 026 O
INSPECTED BY: -ah
WORK IN
PROGRESS:_
AS-BUILT:
INPUT: DATE: Jx ) Oq
W/2007 Town of South Windsor INPSEC 1ON REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT 9 ct) -1 '
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL .
1640 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
-� c��S '
Name of Firm �c�I,S � / Phone No.
Address of Firm S Zip Code
Location of proposed work 7 3 . 3 ' S' 4�1 +
Describe fully nature of permit requested ✓' 1 C/
Starting date Approx. time for completion_
Call Before You 6ig t4o.
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Lad i No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
S / Est. Patch Unit Price
pl
S Est.Patch Cost$
Est.Curb Replacement ft
�j
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
n-> I Est.Traffic Control$
Amt.of Deposit$
Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police Dept.and C.B.Y.D.
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECT[ N WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS UTLINED THE TOWN OF SOUTH WINDSOR'S STREET CUT PE MIT MA UAL.
Signed: Date:
Title: Driver's L cense M
PE IT SHALL BE KE14 ON IOBSITE AT ALL TIMES
Street Excavation Permit 08.doc