HomeMy WebLinkAboutStreet Cut Permit 97 Commerce Way (2) 1000021
PERMIT NUMBER
T O yV
DATE: 01/29/10 oZ G�tG a,� N OF SOUTH W
IND
GIS ID:22500097
MUMS - STREET CU S O R, CT
APPL '—
ICATION# 201000089 - - T PENT
NAME: APPLICAIVP - — PIRATTOND FEE-
NAME PAVING _ ATE: 25.00
ADDRESS: 435 BUC AND SALIN IN _ 01/29/11
SOUTH�OR, �9 ADD _ g LOCATION
7
PHONE - 4 = rEUiIERCE WAY 860-648-1915 _Ar
T REA.TY LLC
- -
CAND ROAD
WORK DESCRIPTI
ON;
pAT — _ �HrINDSOR, CT 06074
_ EI _ -
�'PLICANT AGREES TO FURNISH ���THE TO RNIS ____� L
TOWN OF SOUTH WI H THE _ SWAY
CONNECTION NDSOR FOR A W _,d SOUS ��
FOR PE WITH THIS PE
RM PERMITS AS OUTL THE ND KENa E AMQT
INEDcT IS = 'D REWIRED A ND WN OOIT , MAINTENANCE OR TO REIMBURSE
wi -t ABIDE BY THE RULES
WORK IN
ISSUED gIr = TMANUAL. ULESANDREGUL
ATIONS
1/29/20103:29P DA —
M *** PERMIT TO BE KEPT ON JO ED L -
B SITE AT ALL TIMES*** INSPECTEDB,y
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: c)1 CONTRACTOR: x S
LOCATION: l D ►'�Y� �('�
TYPE OF WORK: ti
DATE INSP NEEDED: DATE INSP: .;i?,
INSPECTED BY: 6D
WORK IN
PROGRESS:�`,; ; «�.fz;�" e X y �' C.,;f 7
S
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: ( DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
a®i6aoof r APPLICATION FOR STREET EXCAVATION PERMIT o 00001 App! No. TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT Permit No,
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm tM-I S �,��i,y,C� A C FAkt;cNG,
Address of Firm Phone No.
�r
Location of proposed work Zip Code
Describe full nature of W M -V
y permit requested
Starting date 20
Approx.time for completion
Call Before You Dig No.
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. f
Show sketch of proposed work or famish
two copies of separate drawing This section to be filled out by
Indicate North Town of South Windsor
S"�� No.cuts
Est.Patch Size(s) A8--sf
Est.Pvt.Thickness—Y—_in.
Est.Patch Unit Price$—iR,5 _jsf
Est.Patch Cost
Est.Curb Replacement—J-6—ff
Est.Curb Unit Price$�_/
Est.Curb Cost$ 1�1 S 00
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$ c:;�,CO
Total Due
O Cash O Check#o0` 7s
Applicant is responsible for contacting
the Police Dept.and C.B.Y.D. Paid By
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 S OUTLIN I HE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: 'S,� y
Date:_
Title., (I
Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08
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