HomeMy WebLinkAboutStreet Cut Permit 310A-1 Nutmeg Road 800028 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 03/31/08
GIS ID: 65103 1 OA I
FEE: 25.00
MUNIS APPLICATION# 200800344
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A'T ION DATE:
03/31/09
APPLICANT . LOCATION
NAME:
ADDRESS: 31 BAKEWELL COUR 1 NUTMEG ROAD. A(k�soCIATES
N RI 02921 ,,
CRASTO .
9 0
VA X,3a
TER,CT 06045
PHONE 401-461-8420
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WORK DESCRIPTION: INS4
APPLICANT AGREES TO FURNISH THE TO
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REQUIRED AND TO REIMBURSE
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THE TOWN OF SOUTH WINDSOR FOR ANY -
84- , a . FO TENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE nl9-l'V4NtT§: I T
IDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S Ut* 91 Y" . MANUAL......
ISSUED BY DATE INSPECTED INSPECTED BY
3/31/20081:47PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:. S � s CONTRACTOR: " - el e7NOas
LOCATION:
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TYPE OF WORK: ( (! 0 ,9 ,I
DATE INSP NEEDED: DATE INSP: Z
INSPECTED BY:
WORK IN
PROGRESS:_- ,��,
AS-BUILT:
INPUT: C DATE:_ O q
W/2007 Town of South Windsor INPSEC RON REPORT 07
a® D°�i APPLICATION FOR STREET EXCAVATION PERMIT CLOD
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT I
TOWN HALL .
1640 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm T l C • N 4 TAW Phone No.F g g - 9y' 5- 2 36 2
Address of Firm (SIA Zip Coded Z
Location of proposed work 316 NUI-1AA(EG. reck OJT
Describe fully nature of permit requested I►l S Yh(_C. J-N6 C P�--I\i
Starting date -2, - 2U-0 Approx.time for completion 3 O►`i Lt S
Call Before You Dig No. a-60
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
S
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$-Air
Est.Traffic Control$
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 1 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.
ned: s� Date: 3 -Z(5 C)Sr,
Ti Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08.doc
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