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HomeMy WebLinkAboutStreet Excavation Permit 129 Foster Road 800205 PERMIT NUMBER TOWN OF SOUTH W I N D S O R, CT STREET CUT PUBLIC UTILITY DATE: 12/02/08 GIS ID:33300129 MUNIS APPLICATION 4 200801894 FEE: 00 EXPIRATION DATE: APPLICANT NAME: METROPOLITAN DISTRICT LOCATION ADDRESS: R 125 MAXIM ROAD bESS 129 FOSTER ROAD HARTFORD,CT 06114 OW1 EI A t d k GORDON G i 9 FdSTER RD PHONE SOUTH WINDSOR,CT 06074 WORK DESCRIPTION: EMER �rC 'AIP APPLICANT AGREES TO FURNISH THE TOWS pF�I.3U'I` f71�SHE�1M4UNT QF BOND REQUIRED THE TOWN OF SOUTH WINDSOR FOR ANY EXRENS,.INCj Q AND TO REIMBURSE CONNECTION WITH THIS PERMIT AND THE FI XC�I IT T�F M l# WITH AND WI L ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF S't�UT�3,�V11�"DS. � 'OWN FOIZ MAINTENANCE OR REPAIR WORK IN STIEET,CIJT PERMIT MANUAL. ISSUED B DATE INSPECTED Iaiaiaoos sass AM *** INSPECTED BY PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: CONTRACTOR:_ 'n'0 J 's LOCATION: 'TYPE OF WORK: iNSP NEEDED: DATE INSP: INSPECTED BY: { WORK IN PROGRESS: AS-BUILT: INPUT: DATE: W/2007 Town of South Windsor INPSEMON REPORT 07 APPLICATION FOR STREET EXCAVATION PERMITS C n Appl. No. TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 i� FEE $25.00 U Name of Firm tl) C Phone No. Address of Firm Zip Code Location of proposed work_ /` l CT j C)-5 Describe fully nature of permit requested_, N ct �,L- Starting date I -)' I - G Approx. time for completion Call Before You Dig No. I r o)6 `1�6& 7 PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch of proposed work or furnish This section to be filled out by two copies of separate drawing Indicate North Town of South Windsor No.cuts 0 Est. Patch Size(s) sf Est. Pvt.Thickness in. Est. Patch Unit Price$ /sf 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 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 CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: Date: Title: Drivers License M PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Street Excavation Permit 08.doc f TOWN OF SOUTH WINDSOR ENGINEERING DEPARTMENT ADDRESS PERMIT NO. SHEET UTILITIES OF INSPECTOR TEMP.PATCH DATE 1NSPECTOR COMPLETION DATE ------------- ------------ - ------------ . F I �. - t �. ' 3 i T 4 - MUP11Te TMAl C"CCT THE METROPOLITAN DISTRICT - PAVEMENT CUT DATE: 11-d9-0� BILL JOB YES❑ IV00� WO# s`f 3 3 e! �JDRESS I a `I r©SlPI< rd TOWN S 'W 1 V'-yVg,2 STATE HIGHWAY YES Q NOP' DRAW KETCH SHOWING LOCATION AND SIZE OF CUTS AND CUT MADE IN CROSS SECTION OF PAVEMENT " STREET 0/- BIT CONC. CONCRETE ❑ PREMIX ❑ o SIDEWALK BIT CONC. a CONCRETE D FLAG ❑ CURB BIT.GONG. ❑ CONCRETE ❑ STONE ❑ DRIVEWAY BIT.CONC. ❑ CONCRETE ❑ GRASS 0 I � �r REASON FOR CUT: 0 Im �• Q� Q NUMBER OF CUTS: _ DATE OF FIRST CUT: //a 9- bu IS JOB COMPLETED: YESQ 0❑ p x Q g FOREMAN: REPLACEMENT PAVEMENT CONTRACT NO.: r7 w I-- V b > BIT.CONG. 0 CONCRETE ❑ PREMIX ❑ Cf� DATE COMPLETED: v . ACCOUNT NUMBER: Clio CALCULATIONS NO. o OF CUT ITEM# ITEM# ITEM ITEM# N Q yN C� V U 0 PRESS HARD, 3 COPIES (ORIGINAL) OPERATIONS UTILITY SERVICES G(YNELLOW)P DEC. 1. 2008 3 : 09PM MDC SYSTEMS REPAIR N0. 573 P. 1 FAX r METROPOLITAN DISTRICT COMMISSION OPERATIONS / SYSTEMS REPAIR 7 x,,/ aF .rD u7// TO: J-Ffj—' f2 6 U L/i- GulNd�.�/f�.oFi�% FROM: hi 41�� o FAX#: __b 72-?0 PAGES: �- PHONE#: . DATE' /2 --0 / .D COMMENTS' SYSTEMS REPAIR OFFICE 125 MAXIM RD. HARTFORD CT 06114 PHONE - (860) 278-7850/ ext_ 3629 JOHN PAGANETTI OR ext. 3615 JEFF REA FAX 9 (860) 550-7961 • Molloy, Catherine From: CallCenter@CBYD2.com Posted At: Saturday, November 29, 2008 8:22 AM Conversation: Locate Request-20084900073 Posted To: CBYD Subject: Locate Request-20084900073 (CALL BEFORE YOU DIG - CT) 11/29/2008 08:21:37 -5G -Cl -GV -OT 1-SW SWINDS -T5 -W3 -------------------------------------------------------------------------- ***** EMERGENCY ***** TIME. .08:20 DATE. .11/29/2008 REQUEST NO. . .20084900073 LATITUDE. .41.8299988 LONGITUDE. .-72.5773585 TOWN. . . . . .SOUTH WINDSOR ADDRESS. . .129 STREET. . . .FOSTER RD NEAREST CROSS STREET. .ELLINGTON RD -------------------------------------------------------------------------- TYPE OF WORK. . . . .EMER WATER MAIN REPAIR AREA IS MARKED. . .YES REMARKS: LOC IN THE ST CREW EN RTE A24 EVA 112908 0820 -------------------------------------------------------------------------- START DATE. . . . . .11/29/2008 START TIME. . 09:30 CIO CALLER. . . . . . . . . .GREG RUSHBY CALL BACK. . . . . . .ANY PHONE #. . . . . . . . .860-251-7274 FAX #. . . . . . . . . . .860-550-7961 a� t� ALT. PHONE #. . . . EMAIL ADDRESS. . . CONTRACTOR. . . . . .METROPOLITAN DISTRICT WATER ADDRESS. . . . . . . . .125 MAXIM RD CITY. . . . . . . . . . . .HARTFORD V. STATE. . . . . . . . . . .CT ZIP. . . . . . . . . . . . .06114 -------------------------------------------------------------------------- EXCAVATOR DOING WORK. .SAME ISSUED TO: DATE: TIME: BY: DATE/TIME ARRIVED: TIME LEFT: COMPLETED BY: CALL BACK: 1) DATE: TIME: BY: 2) DATE: TIME: BY: PERSON CONTACTED: PERSON CONTACTED: 1