HomeMy WebLinkAboutStreet Cut Permit Deming Street 900051 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/19/09 �'" a >
GIS ID:27609999 FEE: .00
MUNIS APPLICATION# 200900
N Y,Ys£.' •,' i,�""spa. §v.
4 IRATION DATE: 05/19/10 521 .,,
APPLICANT A
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NAME: DOUBLE C CONST VCTIQ }": " MIN STREET
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ADDRESS: P O BOX 785 Wflk SOUTH WINDSOR
145 DIVIDEND R04D. WdIVAN AVE
ROCKY HILL,CT 00003 I 1I�SOR,CT 06074
PHONE <._...� ;Y' s <n: ,r y `4
WORK DESCRIPTION: N
x �C DE1IIS'T : T�t3fi`
BUCKT;3I W
APPLICANT AGREES TO FURNISH THE OVUM 6t'A)UT y s AM OI OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AI 'EP 1�IF` MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THEA1f,C�A"fi�k , .. >: 'fTT �IVFL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINEDIIN THE TOWN OIGI�TI iN `S �EU IT MANUAL.
ISSUED BY DAMINsPVCTED INSPECTED BY
5/19/20098:24AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: C cons-te .
LOCATION: t ) VY1 A Q S`r(ee,
TYPE OF WORK: 6ko S , i de 1 o wri ro 'ee-
-Ij
DATE INSP NEEDED: DATE INSP: /Z 910f
INSPECTED BY: Ab
WORK IN
PROGRESS: b'-U.
a
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
009 aa_�t APPLICATION FOR STREET EXCAVATION PERMIT gDao 5/ .
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC.WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074 _Y
FEE $25.00
Name of Fi Phone No. ?&c) '7:2! ,
Address of Fir L2W �.c Zip Code
Location of proposed workruac ,
Describe fully nature'ofpermit request X �5 4c" r I s/G r v� S ,s +r„�, f.,, � -Z
j � r z ct�z ..► r► e � t�
Sta ing date_ A C/ Approx.time for completion_
Cali Before You Dig No. .260 Z Z o l q el s Existing Water.Supply: R Public Water
❑Well
Existing Sewage Service: [9Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
-LENGTH;TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing Indicate.North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
_-(dppN �1�,, Est.Curb Unit Price_$_ /ft
Est:Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Trafflo Control$
`l Ft!S Amt.of Deposit$
(tleII/=GG Total Due$ f-et c -+von
`�\��„� a, ( )Cash ( )Check#
Applicant is responsible for contacting Paid B
the Police Dept.and C.B.Y.D: y
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 OUTLINWliva
E TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date:_
Title: 6 as 4n-1-a rI 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