HomeMy WebLinkAboutWater service beyond the road pavement S 700184 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 10/31/07
GIS ID: 87000348 25.00
MUNIS APPLICATION# 200701775 '..y '"" "'� FEE:
'. ''� _ "�"'• . E1'IRATION DATE: 10/30/08
APPLICANT •° `'LOCATION
NAME: H W LEVACK CO. r
°= tDSS:>%:`: " $.S I20TG ROAD
ADDRESS: 452 MAIN STREET ;.:<...:....
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SOUTH WINDSOR,CT Q. 04:'':;' •t.::: :< :<
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82.tITN ST
SOR CT0
PHONE , . _6074
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WORK DESCRIPTION: WATRRPRVlQE 00 pa,V � ITT
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APPLICANT AGREES TO FURNISH THE TOWN OQJ Rpm SQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANt,;E '" N3 INC,'t :_. ` ::: ;TOE„#p "TENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE'<. PL ;,.: M- ,.::.
:ZC1' "I A.aw
WADE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN Off'66-til WIl 2 '� E j T;RIANU AI
ISSUED BY DA'I E .. POTEI INSPECTED BY
10/31/20078:56AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 70 f �
CONTRACTOR:
LOCATION: 3 "I 9 S -
0
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:_ /1
INSPECTED BY: 91�
WORK IN
PROGRESS: ,f�. �ar I�c�le� a` / A`
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all
AS-BUILT:
INPUT:
DATE: 1 Z�
W/2007 Town of South Windsor INPSECUON REPORT 07
Molloy, Catherine
From: Cal[Center@CBYD2.com
Posted At: Tuesday, November 13, 2007 7:00 AM
Conversation: Locate Request-20074600128
Posted To: CBYD
Subject: Locate Request-20074600128
(CALL BEFORE YOU DIG - CT) 11/13/2007 06:59:54
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***** ROUTINE *****
TIME. .06:59 DATE. .11/13/2007
REQUEST NO. . .20074600128 PREVIOUS REQUEST NO. .20074100143
LATITUDE. .41.8415551 LONGITUDE. .-72.5986599
TOWN. . . . . .SOUTH WINDSOR
ADDRESS. . .348
STREET. . . .STRONG RD
NEAREST
CROSS STREET. .NUTMEG RD N
---------------------------------------------------------------
TYPE OF WORK. . . . .EXC TO CONNECT WTR LINE
AREA IS MARKED. . .YES
REMARKS:
WORKING ON A CORNER
WORKING FROM THE STREET TO THE HOUSE
-------------------------------------------------------------
START DATE. . . . . . 11/16/2007 START TIME. .07:00
CALLER. . . . . . . . . .HARVEY LEVACK
CALL BACK. . . . . . .7-5
PHONE #. . . . . . . . .860-528-0131
FAX #. . . . . . . . . . .860-528-4390
ALT. PHONE #. . . .
EMAIL ADDRESS. . .
CONTRACTOR. . . . . .H.W. LEVACK
ADDRESS. . . . . . . . .49 MASCOLO RD
CITY. . . . . . . . . . . .SOUTH WINDSOR
STATE. . . . . . . . . . .CT
ZIP. . . . . . . . . . . . .06074
--------------------------------------------------------------
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
tirrLIUATION FOR STREET EXCAVATION PERMIT God
TOWN OF SOUTH WINDSOR
�ln��/ �.% t'I ,77', PUBLIC WORKS DEPARTMENT Permit No.
/ TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm
Address of Firm L z�)9 C 'l Phone No.
Location of proposed work
Describe fully nature of permit requested . z- )
l
Starting date
l Approx. time for completion
Call Before You Dig No. Z� 'i2) y s
Traffic Services Control No.
Show sketch of Proposed work or fumish
two copies of separate drawing Indicate North This section to be filled out by
Town of South'Windsor
j Pavement Cut
ti No.cuts '
i
Est.Size of Penn.PatdKs)
Est.PvL Thickness `— in.
r >
Est.Unit Price$
Amt.of Deposit$
Total Due$ _� by
Cash( )Check#��- /
A) ! Permanent Patch -
No. Cuts
Size of Patch(s)
Final Billing
Amt.Due Payee
Amt.Due Town
By
Applicant is responsible for contacting
the Police Dent and C.B.Y.D. Da
AGREE 70 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 OUT NED IN THE
-TOWN OF SQUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed:
Date:_
Title:
Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES