HomeMy WebLinkAboutStreet Cut Permit 00 Victorian Woods Lan 800086 TOWN OF SOUTH WINDSOR CT
PERMIT NUMBER ,
STREET CUT PERMIT
DATE: 06/12/08
GIS ID:91500000
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APPLICATION# 200$00863 w , FE
> 25.00
�r> V. : TION DATE: 06/12 9
CANAPPLI
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NAME: '" ;; Y a OCATION
TELE-NETWORKS ;r'; ".'� w,
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ADDRESS: 31 BAKEWELL COU1T;' .u, '`.` °" .` tea. WOODS LANE
ORIAR WOODS ASSOC
CRASTON RI 02921 n
PHONE 401-461-8420 s `' '; ` WITDSOR,CT 06074
WORK DESCRIPTION:. . r A °; a wp.:•' .: ..::; g
APPLICANT AGREES TO FURNISH THE T6WAdF.
THE TOWN OF SOUTH WINDSOR FOR ANY
'BOND REQUIRED AND TO REIMBURSE
CONNECTION WITH THIS PERMIT AND THE�:I�L� . �,,'
T� R AINTENANCE OR REPAIR WORK IN
FOR PERMITS AS OUTLINED IN THE TOWN OF SP . ABIDE BY THE RULES AND REGULATIONS
• E� T IT MANUAL.
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ISSUED BY DATE INSPECTED INSPECT D Y
6/12/20082:27PM ' PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 2 0 0 0 no CONTRACTOR: ��� ee_:6de)Yes
LOCATION: a 10 0(,
TYPE OF WORK: (le 100 f 1 hG ('Ad
DATE INSP NEEDED: DATE INSP: a W
INSPECTED BY:
WORK IN
PROGRESS:_
AS-BUILT:
INPUT: C V V DATE: D
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT ?f COOSG
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL .
1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm '/y�TUJ012L'-S Phone No 6'600'�S"a3 ice'
Address of Firm ,e Zip Code C'agc)-1
Location of proposed work vYC�(Z�kN tn/�d�I S' Gam.
Describe fully nature of permit requested 12&764<40 J6 C47V
Starting date `ag' Approx.time for completion /JAB!
Call Before You Dig No.
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or fumish
This section to be filled out by
two copies of separate drawing Indicate North Town of.South Windsor
See No.cuts
Est:Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost
Est.Curb Replacement ft
Est.Curb Unit Price$. /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ Ihr
Est.Traffic Control$
Amt:of Deposit$
Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police Dept.and C.S.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 IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Date: -/0 '0
Driver's License M
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08.doc
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