HomeMy WebLinkAboutStreet Cut Permit 435 Chapel Road 900005 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 02/17/09
% , a„
x . FEE: 00
GIS ID: 18000435 �� <s'''.r ' • «v.. .
Er y. IMTION DATE:
MUNIS.APPLICATION# 200900098 '. s.;•w.. F. t ;r a• ' '
sTA r
.LOCATION
APPLICANT
NAME: METROPOLITAN D ; �EL ROAD
::.
' ivMA'IT ASSOCIATES LLC
ADDRESS: 125 MAXIM ROAD �� °` ��''`;` ,Y ':• .v.
HARTFORD,CT 06 MIRE DR
y O TH:V
ANDSOR,CT 06074
PHONE
WORK DESCRIPTION: 1%
APPLICANT AGREES TO FURNISH THE T fl F, a. TI3ND REQUIRED AND TO REIMBURSE
EOR'MAINTENANCE OR REPAIR WORK IN
THE TOWN OF SOUTH WINDSOR FOR AN �X� SSkII �•
CONNECTION WITH THIS PERMIT AND THEkL T. LL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF 5� w .. TL�IT MANUAL.
ISSUED BY DA E IN PECTED INSPECTED BY .
2/17/200910:31AM ***PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CocasCONTRACTOR: c' ,- t$
LOCATION:
TYPE OF WORK: .
. ..DATE INSP NEEDED: DATE INSP:
INSPECTED BY: p
WORK IN
PROGRESS: e a�e n �,k ou.sc a✓ o
low
AS-BUILT:
------------
INPUT: CAM DATE: _ ,=-
W/2007 Town of South Windsor INPSEMON REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT 00-�
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT '
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm �� � Phone No.
Address of Firm Zip Code
Location of proposed work s —A
Describe fully nature of permit request ,4 Pa t1.
Starting date Approx.time for completion
Call Before You Dig No. Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawin Indicate North Town of South Windsor
J No.cuts
Est. Patch Size(s) sf
Est.Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est.Patch Cost$
i ? Est.Curb Replacement ft
1 11 Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.,of Deposit$
f Total Due$
®SIN ( )Cash ( )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 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.
Signed: Date:
Title: Driver's License M
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08
THE METROPOLITAN DISTRICT - PAVEMENT CUT DATE:
BILL JOB YES a NO'�P WO#c; 7g4/
]DRESS �� TO6IVN •R+ r STATE HIGHWAY YES fl NO)d
DRAW SKETCH SHOWING LOCATION AND SIZE OF CUTS AND CUT MADE IN
GROSS SECTION OF PAVEMENT
a` STREET BIT.CONC. ❑ CONCRETE p PREMIX 0
z
SIDEWALK BIT CONC. ❑ CONCRETE D FLAG ❑
CURB BIT GONG. ❑ CONCRETE ❑ STONE ❑
DRIVEWAY 7f!!� „BIT.CONC.,.�O CONCRETE ❑ 1-2-, 4
GRASS
REASON FOR CUT: i C,(,
6
f
DUMBER OF GUTS:
DATE OF FIRST CUT: ' /'4!�
15 JOB COMPLETED: YES�4- NOD
FOREMAN; Lrct0
W
d
REPLACEMENT PAVEMENT QONTRACT NO.:
BIT.GONG. Q CONCRETE D PREMIX ❑
U
alko-le DATE COMPLETED:
ACCOUNT NUMBER;
CALCULATIONS b
Q �
OF CUT ITEM# ITE ITEM# ITEM#
GNI
V
OO
W
LL
r
L
PRESS HARD, 3 COPIES PAVING INSP. OPERATIONS UTILITY SERVICES CONTFIACTOR
(ORIGINAL) tWHITE) (V►rHITE) (YELLOW)
LArabek, Bernard
From: CallCenter@CBYD2.com
Posted At: Wednesday, February 11, 2009 7:24 PM
Conversation: Locate Request-20090701082
Posted To: CBYD
Subject: Locate Request-20090701082
(CALL BEFORE YOU DIG - CT) 02/11/2009 19:23:39
-3W -5G -Cl -GV
-Jl -OT -S1 1-SW SWINDS
-T5 -W3
--------------------------------------------------------------------------
***** EMERGENCY *****
TIME. .19:22 DATE. .02/11/2009
REQUEST NO. . .20090701082 -
LATITUDE. .41.8092700 LONGITUDE. .-72.6030252
TOWN. . . . . .SOUTH WINDSOR
ADDRESS. . .435
STREET. . . .CHAPEL RD
NEAREST
CROSS STREET. .ELLINTON RD
-------------
TYPE OF WORK. . . . .EMER WATER SERVICE REP
AREA IS MARKED. . .YES
REMARKS:
LOC IN PARKING LOT OF HAIR SALON
CREW EN ROUTE
A24 JMM 021109 1922
---------------------------
START DATE. . . . . .02/11/2009 START TIME. .20:30
CALLER. . . . . . . . . .MANNY OCASIO
CALL BACK. . . . . . .ANYTIME
PHONE #. . . . . . . . .860-251-7274
FAX #. . . . . . . . . . .860-550-7961
ALT. PHONE #. . . .
EMAIL ADDRESS. . .
CONTRACTOR. . . . . .METROPOLITAN DISTRICT WATER
ADDRESS. . . . . . . . .125 MAXIM RD
CITY. . . . . . . . . . . .HARTFORD
STATE. . . . . . . . . . .CT
ZIP. . . . . . . . . . . . .06114
--------------------------------------------------------------------------
EXCAVATOR DOING WORK. .SAME AS NOTIFIED
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:
1