HomeMy WebLinkAboutStreet Cut Permit Norton Lane 900099 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/31/09
GIS ID: 64809999
FEE: 25.00
MUNIS APPLICATION# 200900902 - TION DATE: 07/31/10
APPLICA %LOCATION
NAME: TELE-NETWORKS - S 19 LANE
ADDRESS: 31 BAKEWELL COU. � "g
ERI O SOUTH WINDSOR
CRASTON RI 02921 r =
IVAN AVE
'
D R,CT 060742734
PHONE 401-461-8420 -
WORK DESCRIPTION: INST ,L 3PlE
10
APPLICANT AGREES TO FURNISH THE T OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY B MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PER
MIT AND THE T , = LL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SO SIT RMIT MANUAL.
ISSUED BY TE 1NSPE TED INSPECTED BY
u .
7/31/200910:14AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO,: O °J CONTRACTOR:
LOCATION: Vof t � /1
. r
7YPE OF WORK:
..DATE INSP NEEDED:
DATE INSP: L 3 ID
- _ INSPECTED BY:
WORK YN
PROGRESS: nv
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AS-BUILT:
INPUT:—ck— DATE:
W/2007 Town of South Windsor INpSECTION REPORT 07
0.)4PPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
-72
PUBLIC WORKS DEPARTMENT -,;Le
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
-Name of Firm_ "M_s Phone No. 2-3o"Z-
Address of Firm— MYA-S+-d 1`1 (Za Zip Code 09<a
Location of proposed work Aj04TV,47
Describe fully nature of permit requested 31( PL/(, F6#1- CK TV
Starting dato-2_1r4 Approx.time for completion
Call Before You Dig No.38 b 2_(D Ila Existing Water Supply: El Public Water [I Well
Existing Sewage Service: 0 Public Sewer [I Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OFTHE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Irkricate.North Town of South Windsor-
Na cuts
-84
Est.Patch SIze(s)_Sf
Est. Pvt.Thickness in.
Est.Patch Unit Price$_/sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ Ift
Est.Curb Cost$
Est.Traffic Unit Cost$
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.
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 TLI F SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
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
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