HomeMy WebLinkAboutNew Sanitary Lat Street Cut Permits 935 y 0L_�
TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 3628
ntract X.or DOUBLE C:.;CONSTRUCTION LLC
Location :.Zf-CHAP-E€ RD Aa
dress P O; �0- 785 :-4,5 EVANS RD
Type Work NEW SAN LAT %
RGQKY FiIL'I CT 6<6.067
Phone No
Date Insp Needed
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Time Insp Needed —
-------- -- Time In
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Inspected ByFx
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Work in Progress
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Permit No. 3628 Town of South Windsor, CT
Date 11/12/2003 Street Excavation Permit
Expiration Date 11/11/2004
Descrip: CK 3610 $50.00, CK 6,275 .6:276 62'77 $32'00 00 ; 0 :L - 2 PERMITS
Applicant U:oaat,ion
Name DOUBLE C CONS TRUCTION.:LL C �35 H1 pELRD
Addr. P 0 BOX 785 45 $VANS Rb
ROCKY HILL CT 0,5067 T p of Worr: NEW,..8AN LAT;::
Phone ( )
Applicant agrees .tp fur xxsh the Tozv r� uth Wi amount of bond
required and to reimburse;:the Town of South Wardsor f:Or:''ari.,:expenses
incurred by the Tocun< fcsr riiainterianc �} re���x work a�i connactiOn with this
permit and that applicant:.:' familsar " 1th a'nd W1`1 abide by the rules and
regulations for perM1t5 as; outiz ed,..arL; tY�e yp�aaa . SOiit.h Winasbr's Street
Cut Permit Manual.
* * PERMIT `O B$ KEPI ON 3��i ���';� AT ALT TIMES,'
: sr
Issued by �' �� _ Title
Date Completed peoted By
�pYIN SE4
y �
1540 SULLIVAN AVENUE • SOUTH WINDSOR, CT 06074
OR•COC
TELEPHONE (860) 644-2511
June 20, 2006
Certified Mail
Double C Construction LLC
P.O. Box 785
45 Evans Road
Rocky Hill, CT 06067
Re: Street Excavation Permanent Patch Fees
Permit#3628, 935 Chapel Road
Permit #3629, 895 Chapel Road
To Whom It May Concern:
When the Town of South Windsor issued the above referenced permits to you, it collected a total of
$3200.00 for the permanent patch deposits based on available estimates at that time. The actual cost of
the patch work performed on these permits, however, was a total cost of$2890.10. Therefore, the
balance of$309.90 is being refunded to you.
If you have any questions, please contact me at (860) 644-2511, extension 244.
Sincerely,
Jeffrey Doolittle, P.E.
Town Engineer
cc: Melanie D. Crucitti, Director of Finance
SAENGINEERVoy\2G06 Cut Patch Letters\Cut Patch Joy Double C RcMdoc
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REFUND OF DEPOSIT REQUEST FORM
STREET EXCAVATION PERMIT
Request Date: g�
Issue Refund in the amount of $ �5 0 q z q0
From Account# 001-0300-0205-059
To: ��, i
Permitee: I)c.�l7��r-�bte 7,,o LLC,
Address C)
Permit
Number Location
Number Location
PA
Number Location
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Number Location ►��' }�d
Number Location
Submitted By: L"ll-l"
N e Date
Check Issued:
Number Date
Processed by Finance
Name Date
SAENGINEERTORMS\Office Forms\Patch Refund Fonn.doc
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APPLICATION FOR STREET EXCAVATION PERMIT s6z8
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm b� _ Phone No. W 1 1,503
Address of Firm , 44A
Location of proposed work q, C' 4,2 )2c)ad
Describe fully nature of permit requested
Starting date 1111i os Approx.time for completion
Call Before You Dig No 2W3 W 2O N S H Traffic Services Control No.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate dra ing Indicate North
� Town of South Windsor
Pavement Cut
No.cuts /
Est.Size of Perm. Patch(s)
Lot
I� Est. Pvt.Thickness 8 in.
T Est. Unit Price$
Amt. of Deposit$ !<00• 6V
Total Due$ .oo by
Rw d ( )Cash( . 'Check#
Permanent Patch
No. Cuts
Size of Patch(s)
Final B
inkID =.7 � sue✓
Amt. Due Payee
Pi $
Amt. Due Town
F.1I
7 By
Applicant is responsible for contacting 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: ,/,Ld Date: N ,03
Title: (`.4 Driver's License#:_22 Z.j I LI 923
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
► . J, ,
T Fb1:`OF SOUTH I V s'A110S R
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