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HomeMy WebLinkAboutInstall yard drin in front yard and pipe 800191 PERMIT NUMBER TOWN OF SOUTH WINDSOR, CT a. STREET CUT PERMIT DATE: 10/31/08 GIS ID: 68700011 ........... MUNIS APPLIC ATION# 200801 s fig;: <<<:::'> 712 � ;: � , '{''+ ��77�� FEE: 25.00 IRATIO,:..�. N DATE:E: 10/3 9 APPLICANT Y rfr NAME: SKIPS SEPTIC 9 LOCATION ADDRESS: 27 MUDDY BROOD R+QA 11 PA1 ;LANE ELLINGTON, CT OtiO3L7EJSSEL-L RICHARD W&BEVERLY L r 5 11�A�1I:LANE PHONE 860-875-2332 �� H ©UTHVINDSOR a - ,CT 06074 WORK DESCRIPTION: INSTALS CATCH BA D I'IP ,1VT0 BACK OF ..: APPLICA NT AGREES TO F sm %.;<•= THE FURNISH THE0?YZi;4 <; Q.IJT E TOWN OF SOUTH H WINDSOR FOR ANY.EX QF,. OND REQUIRED •., .:. •:. AND TO REIMBURSE MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THE R' I4AN 1 TS F,�1 IAA yV�T A IT ATIONS AB IDE BY THE RULES AND WORK I ' T�`fO:LT F Q�R FOR PERMITS AS OUTLINED IN THE TOWN OF'S ?.UfiFT R'-S S I E TCC;' PERMIT MANUAL. C ISSUED BY DATE INSPECTED I0i31i2008 I0:29 AM *** INSPECTED BY PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: DO 1 CONTRACTOR: r LOCATION:_ 'TYPE OF WORK: �n s 1 t U �r� l�f a i n i n 7-y'D t ) i'n IV -INSP NEEDED: DATE INSP: INSPECTED BY: J WORK IN PROGRESS: f AS-BUILT: INPUT: DATE: W/2007 Town of South Windsor INPSEMON REPORT 07 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 FEE $25.00 Name of Firm Sri/�S' S c �77 G Phone No. g 7 2 3 3 2 Address of Firm P• 0• 3 O x 2 `j e A/C w IV Zip Code Location of proposed work M Z nI Describe fully nature of permit requested /ti rP4 L '7119 iz Starting date Approx.time for completion Call Before You Dig No. o o PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch of proposed work or fumish This section to be filled out by two copies of separate drawing Indicate North Town of South Windsor Aj No.cuts Est.Patch Size(s) sf Est.Pvt.Thickness in. Est. Patch Unit Price$ /sf - Est. Patch Cost$ Est.Curb Replacement ft Est.Curb Unit Price$ /ft j Est.Curb Cost$ Est.Traffic Unit Cost$ /hr Est.Traffic Control$ Amt.of Deposit$ Total Due$ )Cash ( )Check# I is responsible for contacting Applicant P 9 � �' - Paid By the Police Dept.and C.S.Y.D. ' .. I AGREE TO FURNISH TO THE TOW_ N 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 OUTLI D IN , E TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: �-�- Date: /O. 2`f•-U Title: O W N S 7' " _5 k-t P.5 .S� 17C... Driver's License#: r ?26 SRO � PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Street Excavation Permit 08.doc O LAI ' T 451 o Lc�t-i i4� s r.' bEEr- BIT. DRIVE `."'+:.W,;;;,yy / a Rip L� . 25� o . . x a Y v• M. Vf N: Sri �:.. a ► C7 0. a �+� -T.� N e4, �Ta, 3 3. �: a '' 5.0' 4 3 _. . vFRQ�� !�/ . J14.3 3 ivV. 3f 3.F. '