HomeMy WebLinkAboutExcavation for water and sewer laterals 800174 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 10/06/08 "`
:;
GIS ID: 09000250
FEE: 25.00
MUNIS APPLICATION# 200801562 Y'`r.. ">' '
r ',; ` `' EIRATION DATE: 10/06/09
APPLICANT s y `,LOCATION
NAME: CORREIA EXCAVATbRs INC _ �DI�RE S 2 p BEELZEBUB ROAD
ADDRESS: 47 SMITHBROOK T13R""AdE .t 3 R: ROW.N.sO1i KERRY S
GLASTONBURY,C' 06.083. s, I' pX 162
r � 3uTF WINDSOR,CT 06074
PHONE f
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WORK DESCRIPTION: EXCXVvA' IQ { WA�El SF "1VALS
APPLICANT AGREES TO FURNISH THE'I`QWI „DI< C}UTFT'; " ?vI( +}"I;pF' (�TTD REQUIRED
THE TOWN OF SOUTH WINDSOR FOR ANT'EPENSE INC n Q RED AND TO REIMBURSE
f � II''t. biVVN FC7]::MXINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE` 1 i P,i F<IB;: p IAA„WITH,ANL),WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SflU Tk' fDS�t' ...5 TRF 'C J 'P'k IT MANUAL.
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ISSUED BY DATE INSPECTED INSPECTED BY
10/6/20089:02AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: ® / CONTRACTOR:-
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LOCATION:_ O j , z j VIA,
TYPE OF WORK: — �_
_--_- - DATE INSP NEEDED:
DATE INSP:
INSPECTED BY: Bb
WORK IN
PROGRESS: i
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AS-BUILT:
INPUT: DATE:
W/2007 Town of South Windsor INPSEC71ON REPORT 07
�cae�vjf;� APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
j� �- FEE $25.00
Name of Firm e P,,(j ')L 60 -M._I~ Phone No. `�'J
Address of Firm �14 - — 1, Zip Code
Location of proposed work
Describe fully nature of permit requested
Starting date -7 Z rj �i;��' Approx. time for completion
Call Before You Dig No.
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
\ No.cuts
\\/ Est.Patch Size(s) sf
Est.Pvt.Thickness Q' in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$'17 4
AS 0�A ft
Est.Curb Replacement
6 Lz =I Est.Curb Unit Price$. /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
( )Cash Check#
Applicant is responsible for contacting Paid By
the Police Dept.and C.B.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 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.
4
Signed: -7�'t t� lkzi�9�� o ze Date:
Title: AIdm 6&"14 7`j Driver's License#: f1'y:1,i3
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES 0 2 7 G .3
Street Excavation Permit 08.doc
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