HomeMy WebLinkAboutStreet Cut Permit 524 Pleasant Valley Ro TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 9®D1,f�2 CO TRACTOR: ry) �� C
LOCATION: I '
TYPE OF WORK:)
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN L
PROGRESS: ;4 bC /jr�CL r -j_,S X 2 [A J
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: � � DATE: h - 1 1-a 1
W/2007 Town of South Windsor INPSECTION REPORT 07
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900152 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER - STREET CUT PUBLIC UTILITY
DATE: 11/17/09
GIS ID:72900524 FEE: 00
MUNIS APPLICATION# 200901410RATION DATE:
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APPLICANT A LOCATION
NAME: METROPOLITAN DISCI I T
j% RES " 54 P_LEVSANT VALLEY ROAD
sw ADDRESS: 125 MAXIM ROAD OI DAVID THEODORE
HARTFORD,CT 061 % j
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PL 4SANT VALLEY
4
O�JTH INDSOR,CT 06074
PHONE . j� �j-
WORK DESCRIPTION: REPAY 1 IN-CH ' � '
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APPLICANT AGREES TO FURNISH THE T65% SOUTTI W �_ R F. OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY WmsES INCU�E MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE.PPLICAIT l�FAMIL�AT`i ITH AND�WILL ABIDE BY THE RULES AND REGULATIONS
FORPERMITS AS OUTLINED IN THE TOWN OF S( TITWSSS�REST h1tMIT MANUAL.zpp
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ISSUED BY DATE INSIPECTED INSPECTED BY
11/17/200910:52AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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NQV, 17. 2009 8: 52AM -"' MDC SYSTEMS REPAIR'rlu"sox 'rcwtu aall NO. 275 P. 2 Qooz/oo2
APPLICATION FOR STREET ZXCAVATION.PERMIT �} D
TOWN OF SOUTH WINp80R / a
PUBLIC WORKS 0EPAPTN4ENT Peet NO
TOWN HALL '
1540 SULLIVAN AVENUE
soUTH WINDSOR,CT 06074
FEE $25.60
'Name of Firm_
Address'Of Firm —' Phone Nv,
Location of proposed wol,. S, �-
Describe fully nature of permit requestpd Cp E®
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Starting date 0
Call Before You pig No; r AAprox.time for cornpletiv /
THE METROPOLITAN DISTRICT-•PAVEMENT CUTfo f! ifled out b
Town bFSotrffi'Wintisnr
BILL JOB YES p NO pavdmenl Cut
ADDRESS �.� e��, '40.CLft
DRAW SKErCt{SHOWING WCATION ArrD SIZE OF CUTS AND TOWN G[J
CROSS SECTION OF PAVEMENT 'S"'40 of Penn.Patn4(8)
SSL PvL Thidmess =in..
EsL Unit Price$
Q Ia°r� N AmE of Deposft$
Total Due$ by
{ )Cash( )Chock#
Permanent Pates
o No_ Cuf—
Size of Paws)
14,0
Final Billing
Amt Due P y
ee
Amt-Due Town
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�Gv+r z
l GREE I•U rURNfSH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIREL7 AND Tp RElMBURS
TOWN C SOUTH WINDSOR FOR ANY EXPENSES INCURREp By THE TOWN FOR MAIt�fTE
CONNECTION IN
WITH THtS PERMIT AND E THE
THAT I AM FAMILIAR WITH ANC)WILL AHiDE B8'THE RULES AND REGUI flTfON R REPAIR WORK
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PERMITS A3 DUTLINED IN THE TOWN OF SOUTH W[NDSOR'S STEM[=(;j-C�PERMIT MANUAL. +
Signed: -
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• Date• i
Title: f
Drivers License#
PERMIT SHALL BE KEPTON JOSSITE ATALL TIMES
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THE METROPOLITAN DISTRICT - PAVEMENT CUT DATE: H—
BILL JOB YES❑ NOW, WO# 7 t)
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)DRESS :d2 Li S�i e, TOWN Ic LO STATE HIGHWAY YES❑ NO$ ,
DRAW SKETCH SHOWING LOCATION AND SIZE OF CUTS AND CUT MADE IN
¢'
�, CROSS SECTION OF PAVEMENT
j� STREET BIT,CONC. e�- CONCRETE ❑ PREMIX ❑
� ��" ( SIDEWALK BIT.CONC. Cl CONCRETE ❑ FLAG D
CURB BIT.CONC. ❑ CONCRETE ❑ STONE ❑
DRIVEWAY 81T.CONC, ❑ CONCRETE Cl
GRASS Wjkk tv -
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REASON FOR GUT: e'p g,\ tie% Z e 9d-L
NUMBER OF CUTS: "
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DATE OF FIRST CUT.-
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IS JOB COMPLETED: Y % O❑ I $ '
FOREMAN: 73 eo �D LJ l l � 9,/�
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1yAD
REPLACEMENT PAVEMENT CONTRACT NO.:
BIT.CONC. D CONCRETE D PREMIX ❑
DATE COMPLETED:
ocr�. ACCOUNT NUMBER: L.
CALCULATIONS
OF CU LTE ITEM ITE ILL
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PRESS HARD, 3 COPIES {ORIGINAL)° BP(WHITE) UTILITY HITE)1�>=S G�YIELLoW R
NQV, 17. 2009 8: 52AM MDC SYSTEMS REPAIR N0. 275 P. 1
FAX
METROPOLITAN DISTRICT COMMISSION
OPERATIONS / SYSTEMS REPAIR
TO:&60
� �0 00� FROM:FAX#: 1f�— 7240 PAGES:
PHONE#: 7 &4yor f o 0 ¢
0c.( (.v/�f of 1'1': DATE:
COMMENTS:
SYSTEMS REPAIR OFFICE
125 MAXIM RD. HARTFORD CT 06114
PHONE- (860) 278-7850 / ext. 3629 JOHN PAGANETTI OR ext. 3615 JEFF REA
FAX 4(860) 550-7961
Molloy, Catherine
From: CallCenter@CBYD2.com
Posted At: Monday, November 16, 2009 2:48 PM
Conversation: Locate Request-20094700584
Posted To: CBYD
Subject: Locate Request-20094700584 �
(CALL BEFORE YOU DIG — CT) 11/16/2009 14:47:48 '`��
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—W3
------------------------------------------------------------------------
***** EMERGENCY
TIME. .14:47 DATE. .11/16/2009
��c �
REQUEST NO. . .20094700584 �� wi-
LATITUDE. .41.8159255 LONGITUDE. .-72.5988078 � c��t� 1 '
TOWN. . . . . .SOUTH WINDSOR 6,A)
ADDRESS. . .524 p p
STREET. . . .PLEASANT VALLEY RD ` .� 14
NEARESTA
CROSS STREET. .HILTON ST �' �?` 1 � �
--------------------------------------------------------------------------
TYPE OF WORK. . . . .EXC TO REPAIR WATER MAIN LEAK
AREA IS MARKED. . .NO
REMARKS:
WORKING IN THE STREET, GRASS, AND CURB AREA IN FRONT OF PROP.
WORKING 100FT IN ALL DIRECTIONS OF PROP.
--------------------------------------------------------------------------
START DATE. . . . . .11/16/2009 START TIME. .14:46
CALLER. . . . . . . . . .JOHN PAGONETTI
CALL BACK. . . . . . .8-5
PHONE #. . . . . . . . .860-278-7850X3629
FAX #. . . . . . . . . . .860-550-7961
ALT. PHONE #. . . .
EMAIL ADDRESS. . .
CONTRACTOR. . . . . .METROPOLITAN DISTRICT WATER
ADDRESS. . . . . . . . . 125 MAXIM RD
CITY. . . . . . . . . . . .HARTFORD
STATE. . . . . . . . . . .CT
ZIP. . . . . . . . . . . . .06114
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EXCAVATOR DOING WORK. .SAME
ISSUED TO: DATE: TIME: BY:
DATE/TIME ARRIVED: TIME LEFT: COMPLETED BY:
CALL BACK: 1) DATE: TIME: BY: 2) DATE: TIME: BY:
PERSON CONTACTED: PERSON CONTACTED:
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