Loading...
HomeMy WebLinkAboutDriveway Street Cut Permits 24 Judge Lan 800078 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER ,. .. STREET CUT PERMIT DATE: 06/05/08 GIS ID:48300024 FEE: 25. MUNI S APPL IC AT IO N# 20 0800816 080 08 16 00 NPIATI ON DA TE: • 0 6/OS/09 i' PLICAN .. ......:.::.. ]LOCATI ON UDUE. LANE NAME: QUALITY P Q PAVING C 4J ADD RESS: RESS: 1 �N '.. 94 S.M ..AIN STREET.' • 1 Tt: ( .R gw.....:...:.... ANDR STEVEN C&MARJORIE M EAST WINDS _.��< <OR CT iix "•:� l SOR,CT 06074 PHONE 860-523-4182 �i WO RK RK DE SCRIPTION: SC RIP TIO N: D RIVE. APPL IC ANT AG REES ES TO FU RNISH SH THE T O . .,•.(IT,(3I:;$O7D REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANY XPF, STS# JR> E pR'11f'AINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THE ARPLIC I� S" tVETt :::WIH1*p'WZI ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SO J;"]Hi:? . T'pEI IIIT MANUAL. ISSUED BY DATE INSPECTED INSPECTED BY 6/5/200810:56AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: �� CONTRACTOR: I LOCATION:_ o? Li Z:Y� a (r A ve TYPE OF WORK: DATE INSP NEEDED: DATE INSP: INSPECTED BY: IM WORK IN PROGRESS: �� AS-BUILT: INPUT: DATE: ' a- W/2007 Town of South Windsor INPSECTION REPORT 07 a,wyL/vn((,, APPLICATION FOR STREET EXCAVATION PERMIT 946 d-7 6 Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No. TOWN HALL . 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00 Name of Firm Phone No. �,� l Address of Firm u� Zip Code_ Iz o 7 Location of proposed work el Describe fully nature of permit requ sted ;g Starting date Sr 6/9 Approx.time for completion 0 Call Before You Dig No. o - 3 © G 5 PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH ISTYPICALLY 'COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch of proposed work or fumish two copies of separate drawing This section to be filled out by Indicate North Town of.South Windsor No.cuts Est.Patch Size(s) sf 9 Est.Pvt.Thickness in. r Est.Patch Unit Price$ - /sf Est.Patch Cost Est.Curb Replacement ft Est.Curb Unit Price$. ffi Est.Curb Cost S. Est.Traffic Unit Cost$ 1hr Est.Traffic Control$ Amt.of Deposit$ Total Due S ( )Cash ( )Check# Applicant Is responsible for contacting Paid By the Police Dept.and C.S.Y.D. 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 1 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN T E TO N OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: �i Date: v _ Title: v Driver's License M Q L �f,2Z 03 PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Street Excavation Permit 08.doc