HomeMy WebLinkAboutStreet Excavation Permit Pierce Road 800206 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 12/03/08
GIS ID:71409999
MUNIS APPLICATION# 200801903
FEE: 00
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E ?IRATION D ATE: 12/03/09
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APPLICANT' :� <:�• ::�::: ,�. <,•a:..
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NAME: J&H SLATER CONfi N
r ')DRES II RCE 0AD
ADDRESS: 75 COMMERCE WAS' K £ c ` �"
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TOWN16 SOUTH WINDSOR
SOUTH WINDSOR, 1I4IJLI.IVAN AVE
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(�7TFI°�VNDSOR CT 06074
PHONE
860-528-5252
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WORK DESCRIPTION: CONIT1311 , F 9IT7EW�1L O T EI�,WALK PIERCE ROAD
WORK P`REVIOU UT' :'7
k � ��°�x�� �L�:�PERMIT 4206
APPLICANT AGREES TO FURNISH THE T�JW}V 01 SQUT � 1 AMp l�€T pF UOI� D REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY E1'EN3S>I1�IYJI , FjI {iN:pR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THL.APLCAN T�S FAk11AtI P1DV11 L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS
S�OUTLINED IZ�THE TOWN OF' OU'TIf JIND'Sk S T I T PE IT MANUAL.
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ISSUED BY DATE7 S'P` CTED INSPECTED BY
12/3/200811:44AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: LC)—(�k 02 CONTRACTOR: S Ia
LOCATION:_ P
TYPE OF WORK:_-- S�ct
=—=— .DATE INSP NEEDED:
DATE INSP: 1 z o
INSPECTED BY: 0_V
WORK IN
PROGRESS'—
AS-BUILT:
INPUT DATE:_ 1
W/2007 Town of South Windsor INPSEMON REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT 0000(9
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENTS�'� I.�N/lk Pe �Nis
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm_ J �l� )ff�-J�2 Phone No.
Address of Firm (1) ��' ��j/� Zip Code
Location of proposed work f�/6z6r--- /fir)
Describe fully nature of permit requested ' lke &)k `>/{GG(U,,&l Ut d-,a40
Starting date Approx. time for completion
Call Before You Dig No.
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price
lA Est. Patch Cost
Est. Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting the Police Dept.and C.B.Y.D. Paid B y
I AGREE TO yRNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
TOWN OF TH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTI N WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS�A(�UTLINED IN THE TOWN OFF SO SOR'S STREET CUT PERMIT MANUAL.
Signed: r � K,) " t Date:
Title: Driver's License M
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08.doc