HomeMy WebLinkAboutMiscellaneous Street Cut Permits Drake C Permit No. 4189 Town of South Windsor, CT
Date 04/13/2006 Street Excavation Permit
Expiration Date 04/13/2007
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Applicant
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Name JOSLIN CONCRETE X SNOW PLQWTTTG
Addr. 474 CARPENTER RO.AIJ
COVENTRY CT 06238 Ty�s'e of #Rrr)U 31SCELLAN
Phone (860)291-8456
Applicant agrees to furrisy;the T..ows So�Yh, Windsor the aayount of bond
required and to reimbUzrae ttze 'how
1 .O SF 1l� W e 3or f�zr ahy #?: pepses
incurred b the Town f Y .m �elance or repair of sn; bnnectio'n with this
permit and that applicant 3i<:::::> :°_ :,::>>:. '
PPsa<#�ii3"q b.y th'e rules and
regulations for permit's as od.ti`.ned z4 '-- Jr * o€ South W Incisor's Street
Cut Permit Manual.
* * PERMIT TO $ tCSPT QN"J>B SATE AT Llr 'TIM$S
Issued by
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4189 Cont raet'or IJOSLTk""CG,INCRETE N SNOW PLOWING
Location PdtTress;;i '.'"':474 ARDENT 'RROAD
Type Work MISCELLAN GgyENT9Y`Ci06218,
Phone 94 (86 #.)29i-84S6
Date Insp Needed
Time Insp Needed tjCor, — — Time Ines'.
Inspected By
Work in Progress
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4189 Cont,raet'Sr„JOSLI' "VON.CRETE N SNOW PLOWING
Location Adfl`r :4esr474 JR?'ENTfiR<;ROAD
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AREA CODE NUMBER ION
❑ FAX
❑ MOBILE 3 4 '3-9 S I
AREA CODE NUMBER TIME TO CALL
TELEPHONED PLEASE CALL
CAME TO SEE YOU WILL CALL AGAIN
WANTS TO SEE YOU RUSH
RETURNED YOUR CALL WILL FAX TO YOU
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SIGNED
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TOPS ?FORM 4005
LITHO IN U.S.A.
04/26/2006 WED 16:22 FAX 860 644 7280 South Windsor Town Hall 0001
*********************
*** FAX TX REPORT ***
*********************
TRANSMISSION OK
JOB NO. 1258
DESTINATION ADDRESS 92363951
PSWD/SUBADDRESS
DESTINATION ID
ST. TIME 04/26 16:22
USAGE T 00' 20
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RESULT OK
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4189 Cont 8r1J0S "gyp CRETE N SNOW PLOWING
Location ree 74 NT OAD
Type Work MISCELLAN R6 0 2
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Date Insp Needed
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Bernard Drabelc Locate Request-20061503102 Page 1
From: <CallCenter@CBYD.com>
To: <cbyd@southwindsor.org>
Date: Thu, Apr 13, 2006 3:42 PM
Subject: Locate Request-20061503102
(CALL BEFORE YOU DIG -CT) 04/13/2006 15:35:18
-5G -Cl -CW -GV
-OT 6-SW SWINDS -T5
--------------------------------------------------------------------------
***** ROUTINE*****
TIME..15:35 DATE..04/13/2006
REQUEST NO...20061503102
LATITUDE..41.8119544 LONGITUDE..-72.5679626
TOWN......SOUTH WINDSOR
STREET....DRAKE CT/AUSTIN CIR
NEAREST
CROSS STREET..
--------------------------------------------------------------------------
TYPE OF WORK.....EXC TO INSTL SIDEWALK& HANDICAPPED RAMP
AREA IS MARKED...YES
REMARKS:
WORKING ACROSS THE ST FROM THE INTER ON THE SIDE OF THE ROAD.
--------------------------------------------------------------------------
START DATE......04/19/2006 START TIME..08:00
CALLER..........MARK JOSLIN
CALL BACK.......8-5
PHONE#.........860-291-8456
FAX#...........
ALT. PHONE#....
EMAIL ADDRESS...
CONTRACTOR......JOSLIN CONCRETE CO
ADDRESS.........474 CARPENTRY
CITY............COVENTRY
STATE...........CT
ZIP.............06238
--------------------------------------------------------------------------
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:
APPLICATION FOR STREET EXCAVATION. PERMIT
TOWN OF SOUTH WINDSOR Permit No
PUBLIC WORKS DEPARTMENT
TOWN HALL S o 2,q 1 _ L4 C
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074 SC S
FEE $25.00
Name of Firm J o s 1 n, Cov n c -e 6
Address of Firm Phone No. 'I �y5
Location of proposed work /�
( hCn n .� i �, 11 rn ` -C,
Describe fully nature of permit requested
Starting date H t �t O
Call Before You Dig No. Approx. time for completion
Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing Indicate North This section to be filled out by
Town of South Windsor
Pavement Cut
��. No.cuts
Est.Size of Perm.Patch(s)
d \ r l
J I ,�9 ) Est.Pvt.Thickness in.
�1 nGl,Cc�•
C r f J Est.Unit Price$
1�v S Amt.of Deposit$
T Total Due$ by
( )Cash( )Check# .
Permanent Patch
No. Cuts
Size of Patch(s)
Final Billing
Amt.Due Payee
Amt.Due Town
BY-
Applicant is resp2nsible for contacti
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the Police Dept.and C.B.Y.D. Dat
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 E TO N OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: e
Date:_ �/ a 6
Title:
Driver's License#: �K O 2 73
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES