HomeMy WebLinkAboutStreet Cut Permit 76 Sally Drive Y—S
900057 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
— a Y' STREET CUT PERMIT
MR -I _
DATE: 05/26/09
GIS ID:79500076 �/
ZAN
MUNIS APPLICATION# 200900562 � FEE: 25.00
EYRATION DATE:
!� 05/26/10
APPLICAII41 All
NAME: AIROLDI'S INC. LOCATION
ADDRESS: P O BOX 71 g� y� � r
EIS li O AWRENCE&LAURA L
SOUTH WINDSOR, '�0 40
3 - 5 - -: 6 at,''DRIVE
PHONEY `- - UTI INDSOR,CT 06074
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WORK DESCRIPTION: DRIA AY%
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APPLICANT AGREES TO FURNISH THE TOV"I gj _
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THE TOWN OF SOUTH WINDSOR FOR ANYTI` OND REQUIRED AND TO REIMBURSE
� OWFR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE JVhLj_� F LIB HA WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SO `T ITINSTI; _E IT MANUAL.
ISSUED BY DATE SP CTED INSPECTED BY
5/26/2009 11:23 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOa INSPECTION REPORT
PERMIT*NO.:_ _ =_s CONTRACTOR
LOCATION: "76 I ► U�
TYPE OF WORK:
-DATE INSP NEEDED: DATE INSP: ��
i
INSPECTED BY:____8
WORK IN
PROGRESS:
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AS-BUILT:
INPUT: C �� DATE: c
W/2007 Town of South Windsor INPSEMON REPORT 07
b0 991�1 APPLICATION FOR STREET EXCAVATION PERMIT 00v,S
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date.SA
SOUTH WINDSOR,CT 06074
< FEE
Name of Firm Phone No. �0 '301-CP il
Address of Firm 0Q>O-7 4Zip Code
Location of proposed work
Describe fully nature of permit requested '
Starting date Approx.time for completion
Call Before You Dig No. 7I&SCP46
QL C, Existing Water Supply: El Public Water El 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 fumish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
0 No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est.Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
j Z Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
2Z Amt.of Deposit$
Total Due$
ZZ— ( )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 N THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date; �C
Title: Driver's License#:
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