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HomeMy WebLinkAboutBark park relocation Street Cut Permits vvVVJJ PERMIT NUMBER TOWN OF SOUTH WINDSOR' CT STREET DATE: 04/15/08 T CUT PERMIT GIS ID:62400150 UNIS APPLICATION# 200800460y IF h,RAT 0 IO 0 A P f; N D A T E• r`yfn P L I C A 0 N 4 1 5 NAME: 9 1V V R O N ,. MENTAL .<.........:..... ::: :.> .. ADDRES SERZzIC S: 90 FC< by: BRoo hm.: LOCATION KFIELD S TION T `.R S :- O f l`1 V SOUTH W `;'h Y.: 1`5:4 E ERS R INDSO <��,�� n��:: OAD R,C `. PHONE D SOR TOWN O O F N 4 E 8 6 R 1 0- S••5 2 R 8-9 5 d AD 0 >0 III D S O R C T 6 W ^/ / O 4 WORK DE SCRIPTION: S C P T I O B A RK: P ..; I: C H may. I E F.R�., �y. '. APPLICANT WAS' >d ,..: W AGREES TO "' n;MI.- OWN ELK THE FURNISH TOWN THE T :. "f`h y" OF SOUTH Si3T:.::: .„,... :: CO WINDSOR FOR � H`�?t `t�� 1` •sat :!: CONNECTION WITH THIS PERMI ANY'1yp ? SJ . x`.` OLP'O :`BC517`RE REQUIRED T AND THE API1N1`I;, ._<; z1 ram';. Q RED AND TO REIMBURSE FOR PERMITS AS OUTLINED IN THE TO FA1II, V61TH AND> ....:, A7NTENANCE OR REPAIR WORK IN OF SnUT1T rDSR}` ' Ii B''ABIDE BY E THE RULES .. . 1R1ITT MANUAL. AND REGULATIONS ISSUED BY TE : 4/I5/20083:45PM *** DA PERMIT TO BE KEPT ON JOB SI INSPECTED T E AT ALL TIME S*** INSPECTED BY TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: CONTRACTOR: S LOCATION: 0 c-W, .� TYPE OF WORK: �,J)car a1" t 4. c, _j , DATE INSP NEEDED: DATE INSP: INSPECTED BY: WORK IN vI PROGRESS:_ C>K la A-sR- �.. i �"�-- i✓to2.� '�vA S©,]l �es� � dQu --ac� c, J AS-BUILT: INPUT: DATE: W/2007 Town of South Windsor INPSEC 1ON REPORT 07 APPLICATION FOR STREET EXCAVATION PERM Appl. No. � TOWN OF SOUTH WINDSOR IT . PUBLIC WORKS DEPARTMENT Permit No. TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm EE Vi Address of Firm p Phone No.<T D—52 j DQ Location of proposed work -Sol— Zip Code 6 p Describe fully nature of permit requested I �C-44 k' IS o Neu Pr,S g©Q�Q Starting date ° Call Before You Dig o. Approx. time for completion PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH ARE LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TY B COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch of proposed work or furnish two copies of separate drawing This section to be filled out b Indicate North Town of South Windsor No.cuts Est.Patch Size(s) sf Est.Pvt.Thickness in. Est.Patch Unit Price Est.Patch Cost S Est.Curb Replacement 0 Est.Curb Unit Price Est.Curb Cost S Est.Traffic Unit Cost$ mr Est.Traffic Control$ Amt.of Deposit$ Total Due S (Applicant is responsible for contacting )Cash ( )Check# the Police De t.and C.B.Y.D. Paid By f I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR RE CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AN REGULATIONS FOR TO REIMBURSE THE PERMITS A D IN T TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANU D PAIR WORK IN Signe Title: �/� Date. Q Driver's License#: PERMIT SHALL BE KEPT ON JO SITE AT ALL TIMES Street Excavation Permit 08.doc