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HomeMy WebLinkAboutWatermain repair Street Cut Permits 21 E 700007 TOWN OF SOUTH WINDSOR, CT PERMIT.NUMBER STREET CUT PERMIT DATE: 03/12/07 GIS ID: 29400021 FE E: M .00 iINIS APPLICA TIO N# 2 0070 023 8 XPI RAT I ON DA TE: E: 03 1/ 1/0 8 O APPLICANT NAME: CATION RE Hk©ELDI✓GOEIV IB HAROLD&JULIE� OOD DRIVEADDRESS. � 1; D.G EWOOD DR IVE VE UTI°I>W' H ONE 1NDSOR CT 0 6074 P WORK DESCRIPTION: WAT�RI�AIN I�I'AII� € .. APPLICANT AGREES TO FURNISH THE TOWN OF SI'SUTI WV[N,IjSOR; MOT T1`J OF I30ND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANC,EENSI~S:]I1 $ TOE FAR 1VIAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THE.APPLIGANT3S FA I'1'IJ AND WILL'ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF OU H INT SR S TRI ET,C[J I•i 1RMI`T MANUAL. I10 ISSU BY .::DA E TED INSPECTED BY 3/12/20073:46PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: � CONTRACTOR: 0/7 LOCATION: EJ (21,00oCi �'I ADDRESS: TYPE OF WORK: Z DATE INSP NEEDED: 3 " _5 -0 ( DATE INSP: INSPECTED BY: WORK IN PROGRESS: X x 2 4 6,11 s INPUT: C% � DATE: t 0310AR. 12, 2004, 2:08PMkx ss,MDC SYSTEMS REPAIRadsor Town Hall N0, 470 P. 2`�`""� APPLICATION FOR STREET ExcAvi noaPERMIT TOWN OF SOUTH WINDSOR Permit o PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVERUE SOUTH WINDSO►,,CT 06074 FEE•us,do "Name of Firm �/.. Phone Address o of Firm N Location of proposed wo d Ar OF Describe fully nature of Permit requestQd �r �. Starting date;"• —//' . Call Before You Dig No. / Approx.time for completion Traffic Services Control No. Showsketch of Proposed vwrk or famish two des of separate drawing Indicate NOrltt This seeHon-to be filFed out by • Tor Soufh'Win�sor . - •`�� Pavement Cut No.cuts FA,Size of Perm.Paboh(s) Est PvL ThkknEss in. � ,(1 Est Ura Pries Amt.of Depose S . lam- Total Dw$ by ( )Cash( ' check# P.crmanent Patch No, Cuts Size of Patch(s) Final Bluing Amt Due Payne Arnt Due Town By APpilcant is re ble for conta . the PONce DeL and C.B.Y.D, - ITOWN AGREES TO FURNISH TO THE TOWN OF SOS WINDSOR THE AMOUNT OF BOND RE'QUIRf~D AND TO REIMBURSE THE CONK OF SOUTH THIS FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE-OR REPAIR WORK IN. CONNECTION WITH TMIS P tT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGU[ATiONS FOR PF�iTS AS OUTU ED HE TOWN OP SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Sig Date: _F-•AP —,0 . Title: Driver's License#: •PERMIT SHALL,BE KEPT ON JORS[iE AT ALL TIMES rahek- Locate Request uest-2007110 r �� 9. -. 0035 Berns t From: <CallCenter@CBYD2.com> To: <cbyd@southwindsor.org> Date: 3/11/07 5:30PM Subject: Locate Request-20071100035 (CALL BEFORE YOU DIG -CT) 03/11/2007 17:26:55 -5G -C1 -GV -OT 2-SW SWINDS -T5 -W3 -------------------------------------------------------------------------- ***** EMERGENCY***** TIME..17:26 DATE..03/11/2007 REQUEST NO...20071100035 LATITUDE..41.8243083 LONGITUDE..-72.5913658 TOWN......SOUTH WINDSOR ADDRESS...21 STREET....EDGEWOOD DR NEAREST CROSS STREET..MARILYN ROAD -------------------------------------------------------------------------- TYPE OF WORK.....REPAIR WATER MAIN AREA IS MARKED...YES REMARKS: LOC IN THE STREET IN FRONT OF PROPERTY CREW EN ROUTE A/24 LKD 03/11/2007 @ 17:25 -------------------------------------------------------------------------- _ START DATE......03/11/2007 START TIME..18:00 ....�}c:1 t^.,� ��1. /!•._;;{ .../ "" .` a _. ` �t CALLER..........GREG RUSHB'ywCV - ; CALL BACK.......ANY fL_P PHONE#.........860-251-7274 FAX#...........860-550-7961 ALT. PHONE#.... EMAIL ADDRESS... CONTRACTOR......METROPOLITAN DISTRICT WATER ADDRESS.........125 MAXIM RD CITY............HARTFORD I STATE...........CT ZIP.............06114 -------------------------------------------------------------------------- EXCAVATOR DOING WORK..SAME ISSUED TO: DATE: TIME: BY: DATE/TIME ARRIVED: TIME LEFT: COMPLETED BY: Bernard Drabek-Locate Request-20071100035 Page 2 CALL BACK: 1) DATE: TIME: BY: 2) DATE: TIME: BY: s PERSON CONTACTED: PERSON CONTACTED: e�j 3L� ti t I f 1 r 4 F 1 t V a THE METROPOLITAN DISTRICT - PAVEMENT CUT DATE: - 07 BILL JOB YES❑ NO A WO# 5 3G 7 o ADDRESS 1 e GcJ cjcl� I,I - ' TOWN �� W i1 0 r' STATE HIGHWAY YES D�Ib DRAW SKETCH SHOWING LOCATION AND SIZE OF CUTS AND _ CROSS SECTION OF PAVEMENT CUT MADE IN STREET BIT CONC.)o(o'CONCREfE D PREMIX ❑ SIDEWALK_ BIT,CONC. ❑ CONCRETE D FLAG CI CURB BIT.CONE Q CONCRETE ❑ STONE ❑' ! DRIVEWAY BIT.CONC. ❑ CONCRETE ❑ V REASON FOR CUT: a I . NUMBER OF CUTS:. DATE OF FIRST CUT r is JOB COMPLETED,, )) YES O❑ FOREMAN: REPLACEMENT PAVEMENT• CONTRACT NO o �.. a d SIT CONC. ❑ CONCRETE ❑ PREMIX ❑ 0 3 -DATE COMPLETED: I 1 r / ACCOUNT NUMBER: 5 I ,� GALCULATIONS a. <C-4 OF lyQ 4--. (S� .� U ITEMS ITEMS ! ITEM o - PRESS HARD, 3 COPES PAVINGFjraj ASP. OPERATIOC�lS UTILITY SERVICES CONTRACTOR (ORtRINAL) (WHITE) (WHITE) (YELLOW) -MAR, 12. 2007 1 : 29PM OPERATIONS. NO- 681 P. 1 The MetropoRtan DIstdctF-4 - Wxter suppZy*EnyuomcataI servicos s geohi��fo�oa : " ' , - - s T0: From: O Fax: (Cf�� 72�'� Pages: -� Phone: 6 Yq ' `2 5'/� ACT. 2��Date: :v 3 CC: T< gent `]For Aeview QPIease comment nPlease Reply comments: 125 Maxim Road Rmtford, CO-1=t tic-at 06114 telephone:(860)278=7850 exf3609 (860)527-515$ ' 03/12/2007 MON 14:08 FAX 860 644 7280 South Windsor Town Hall 14001 ********************* *** FAX TX REPORT *** ********************* TRANSMISSION OK JOB NO. 3177 DESTINATION ADDRESS 95507961 PSWD/SUBADDRESS DESTINATION ID ST. TIME 03/12 14: 08 USAGE T 00' 22 PGS. 2 RESULT OK 7671 Date 3.) pages post IV Fax Note From To�� Q Co. CoiDept. On `. phone Phone# Fax# 7d80 Fax#