HomeMy WebLinkAboutNew Sanitary Lat Street Cut Permits 785 TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 2894 Contractor CALDEIRA CONSTRUCTION
Location 785 CHAPEL ROAD Address 6 BANFIELD LANE
Type Work NEW SAN LAT BLOOMFIELD CT 06002
,Phone No. (860)242-7017
Date Insp Needed bate Insp: ��,��9 15;
Time Insp. Needed
Tire- Insp
Inspected By
Work in Progress
Input Date tZ17Zf
PermTtNb. 2894
Date,,)`* Town 'of South Windsor , CT
11J18/1999 Street Excavation Permit
Expiration Date 11/17/2000
Descrip: SANITARY FOR HOUSE
Applicant Location
4,
Name CALDEIRA CONSTRUCTI(JN ; '786 ,b-HAPEI; ROAD
Addr. 6 BANFIELD LANE
BLOOMFIELD CT 06002yre cif �Vok tNEW SAN LAT
Phone (860 )242-7017y
Applicant agrees to
g tht WI'a s r the amount of bond
required and to reimb vrs ; � Ton hth 1 x fsor 'for any expenses
incurred by the Town 'for^ a44 to �cr ;
a , , �pait* Vork "`in connection with this
icant � 1labide by the rules and
permit and that appl
regulations for permas as,' uajj 11 �f� i ne .youth Windsor's Street
Cut Permit Manual .
* * ERMiT TO'` $ KFP QR_ jQQ S'$TE AT, ALL TIMES.
......
Issued by
T;j t)l e �-
Date Comp l e ed ii Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR ]
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm— el rvL R
°1�. Phone No.
Address of:Flrrn�4' 'C_ _j:L6 C,n
Location of proposed wor
Describe fully nature of permit requested
Starting date Approx.time for completion
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two.copies of separate drawing
�' Pavement Cut
Indicate North t9 Prop.size of cut '7 Y 3
No.cuts
Amt.of Deposit$ �O 3.94 by
{)Cash{heck#
W NAk1 N Cut size after Perm. Patch
No. Cuts
f)40)1ia Final Billing$ Cal
Amt. Due Payee$��
Amt. Due Town$
Applicant is responsible for contact! g by date
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: 4 er, D.L.#
PERMIT SHALL BE KEPT ON 3OBSITE AT ALL-TIMES.
Standard Formsftmtits eet xc v i4r�Perrmitdnc-------------_------ ----- -- ----.----- --.-------- --- .-
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° 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CT 06074
t�OSOR'c° TELEPHONE (860) 644 2511
June 21, 2006
Certified Mail
Caldeira Construction Inc.
580 Forest Rd
West Suffield, CT 06093
Re: Street Excavation Permanent Patch Fees
Permit #2894, 785 Chapel Road
Permit#3833, 495 Pleasant Valley Rd
To Whom It May Concern:
When the Town of South Windsor issued the above referenced permits to your organization, it
collected $1863.94 for permanent patch deposits based on available estimates at that time. The
actual patch work has been completed and resulted in a total cost of$952.20. Therefore, the
balance of$911.74 is being refunded to you.
Permit Address Deposit Cost Refund
2894 785 Chapel Road $303.94 overlaid $303.94
3833 495 Pleasant Valley Rd $1560.00 $952.20 $607.80
$911.74
If you have any questions, please contact me at (860) 644-2511, extension 244.
Sin erely, ^ C
effrey Dolittle, P.E.
Town Engineer
cc: Melanie D. Crucitti, Director of Finance
S:\ENGINEERVoy\2006 Cut Patch Leum\Cut Patch Joy Cafdc'vand.doc
i
REFUND OF DEPOSIT REQUEST FORM
STREET EXCAVATION PERMIT
Request Date: / U 4
Issue Refund in the amount of $ I �T
From Account# 001-0300-0205-059
To:
Permitee: CL ucf"lrD✓1 -:L�l C
Address �j`�C EDKES+ I-ed
LT O(pc)q-ls
Permit q C Y) Pd
Number Location
Number Location
Number Location
Number Location
Number Location
Submitted By: �2r/u 4
Nay6e Date
Check Issued:
Number Date
Processed by Finance
Name Date
SAENGINEERIFORWOffice Fofm Patch Refund Fonn.doc