HomeMy WebLinkAboutWater Street Cut Permits 38 Ident Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No M Contractor GLENN CONSTRUCTION CORP.
Location � J p Address 86 SANRICO DRIVE
Type Work WATER MANCHESTER CT 06040
e No. (860)643-8040
104,
Date Insp Needed n 57/ r3 03
Time Insp Needed ff
Inspected By
Work in Progress Acam"" X—I
4 .IF
j I!E�� 44->
Date ---�`
*Pe t No. 3428 Town of South Windsor, CT
D e 11/06/2002 Street Excavation Permit
Expiration Date 11/06/2003
Descrip: SERVICE ON STRONG RD - TOBBACCO VALLEY SAN.
Applicant » Location
Name GLENN CONSTRUCTION P. D ROAD
Addr`. 86 SANRICO DRIVE
MANCHESTER CT 060 ,j WATER
Phone (860)643-8040
Applicant agrees t t in sor the amount of bond
required and to rei T uth or any expenses
incurred by the Tow t n epa n connection with this
permit and that appli a bide by the rules and
regulations for perm ' t a. outh Windsor's Street
Cut Permit Manual .
Q xj
* PERMIT 'C ALL TIMES.
Issued by, SOD . Oi. �/ I
Date Completed Inspected By -��
,0*N SZq
� ~ J T-ov� O-P Sou�
G `
w` 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CT 06074
soR CO TELEPHONE (860) 644-2511
June 20 2006
Certified Mail
Glenn Construction
86 Sanrico Drive
Manchester, CT 06040
Re: Street Excavation Permanent Patch Fees
Permit#3428, 38 Ident Road
To Whom It May Concern:
When the Town of South Windsor issued the above referenced permit to your organization in
May of 2003, it collected $80.16 for a permanent patch deposit based on available estimates at
that time. Our records indicate that the cut was never performed therefore, the deposit of
$80.16 is being refunded to you.
Permit Address Deposit Cost Refund
3428 38 Ident Road $80.16 No cut $80.16
If you have any questions, please contact me at (860) 644-2511, extension 244.
Sincerely,
Jeffrey Dolittle, P.E.
Town Engineer
cc: Melanie D. Crucitti, Director of Finance
SAENGINEERVoy\2006 Cut Patch Ldtas\Cut Patch Joy Gtenn ReUm
REFUND OF DEPOSIT REQUEST FORM
STREET EXCAVATION PERMIT
Request Date:
Issue Refund in the amount of $ p (p
From Account# 001-0300-0205-059
To:
Permitee: G I ery-1 Cb CrD+rLIC+l'0n
Address Z(o �S gnn'co
Permitj -{—
Number Location
Number Location
Number Location
Number Location
Number Location
Submitted By:
Naqfie Date
Check Issued:
Number Date
Processed by Finance
Name Date
SAENGINEER\FORMS\Office Forms\Patch Refund Form.doc
r
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm iLC �-/ti' �6A,' �,r Phone No. =L `� 0
Address of Firm , 'fit c O Z12 -2
Location of proposed work is-lul a-°-i 7 3 y: j b__, T
-r-u o n-cc b I i ai-c l-e V,4,'r-4 7-c cl A i
Describe fully nature of permit requested— �ATV iZ_ 5 C l%;i c f
Starting date Approx.time for completion / DAY,
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop. size of cut A9
No. cuts
3 Uf'-N l Amt. of Deposit$ go, /,0/ by
® ()Cash o Check# Z s S d S 11.75- 1
C�
! a
5�e rz v I C e Cut size after Perm. Patch
L-- No. Cuts
J Final Billing $C'L-+
k Amt. Due Payee$ I�� ` Q7"
Amt. Due Town$
Applicant is responsible for contacting 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: + �1 . \_��-'`--�- Date: /�C�V 2-c%U2--
Title: D.L.#: r�i ( �1 �`J 4= j�]
PERMIT SHALL BE KEPT ON 3OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc