HomeMy WebLinkAboutRemove and replace driveway Street Cut P (4) 800184
PERMIT NUMBER TOWN OF SOUTH W I N D S O R, CT
STREET CUT PERMIT
DATE: 10/21/08 t<
GIS ID:27600649
UNIS APPLICATION# 200 642 '';'•: :f.. ,<...:..<:
801
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FEE:
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25
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�pI f� RA T I O N DATE:E•
APPLICANT 10/21/09
NAME:
CENTRAL SEALING C .IC LOCATION
`DRESS 150 SUNSET RIDGE DRI1 �pRESS 619 DEICING STREET
EAST HARTFORD CF 06 0S S LR BRITTON ROBERT E
PHONE �. 40P7E N
T�G�STREET
SOR,CT 06074
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WORK DESCRIPTION: K ,)
REIVIOts
APPLICA NT AG
REES
RE E S TO
URNIS
THE.�p y.
THE TO Ol > •_;�„
TOWN OF SOUTH :•
WINDSOR FOR ANY;ENPENSE'S,,;Il <: : . >< : 'T QF BOND REQUIRED AN
CONNECTION WITH THIS PERMIT AND THE°,4 Dr) d NT TS F�1IvIII I"WI F D TO REIMBURSE
TOWN P6kMAINTENANCE OR REPAIR WORK IN
FOR PERMITS AS OUTLINED IN THE TOWN OF '... ;WI�Tp�Ii' STREET BUT PERMIT MANUAL.
AND„WILL ABIDE BY THE RULES AND REGULATIONS
D
ISSUED BY
DATE INSPECTED
10/21/2008 2:21 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** INSPECTED BY
TOWN
OF SOUT
H WINDSOR INSPECTION REPORT
PERMIT NO.: r C7 I CONTRACTOR: 6 efl-,('1 LedA
LOCATION:_ 4
TYPE OF WORK:_ 1 �P ck�C
_=_= -DATE INSP NEEDED:
DATE INSP: Z //i 0 f
INSPECTED BY:
WORK IN
PROGRESS:
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AS-BUILT:
INPUT: DATE: "
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT (--0
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm Phone No
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t u,�.L�.��� a�C�• .
Address of Firm Zip Code 2614f
Location of proposed work
Describe fully nature of permit requested A?e�J),)j(' (4- A-C"42 1!�(L' L7'u' La
Starting date /'-/Z J s' Approx. time for completion E Z) k
Call Before You Dig No. '
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
Est. Pvt.Thickness in.
_I Est. Patch Unit Price$ /sf
- Est.Patch Cost$
Est.Curb Replacement ft
,•, F�;, J Est.Curb Unit Price$ /ft
C,�-Y Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
{ Est.Traffic Control$
i
Amt.of Deposit$
Total Due$
O Cash O Check#
Applicant is responsible for contacting Paid By
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 MP THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OU LINED IN HE OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL
Signed: Date: lol _17�`
Title: r—z /"- Driver's License
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08.doc