HomeMy WebLinkAboutStreet Cut public utility 499 Rye Street 900006
PERMIT TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 03/04/09 '" `` v,,.
GIS ID:78600499 :.`:,,
h." FEE: .00
MUNIS APPLICATION# 200900159 `
RATION DATE:
APPLICAh :; TION
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NAME: YANKEE GAS ;k 1 M : S = ""� RY,FTREET
ADDRESS: EA PROSPECT HILL
ANxDONNA L
WINDSOR,ST Ctl "IT ET
-H: INDSOR,CT 06074
PHONE 860-292-2242
WORK DESCRIPTION: IN,'Tj �I2 rfl
APPLICANT AGREES TO FURNISH THE Tq4�OF S �J 1 ND REQUIRED AND T^ ^ Q O REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EX1?E SE3 G T 1 ai Q FOR'MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE 'gf C jT TRH OAL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE T�O WN OFTI �f1S S OUT IT MANUAL.
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ISSUED BY DATE INSPECTED INSPECTED BY
3/4/20093:12PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I C0006
CONTRACTOR:_ p�
LOCATION:_
TYPE OF WORK: 1 V1 S LLB vr1-aj
-DATE INSP NEEDED: DATE INSP: J oo _
INSPECTED BY:
WORK IN
PROGRESS: ,.JOlk I U w� pa"-s c f D
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INPUT: W`-- DATE: p
W/2007 Town of South Windsor INPSEMON REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: —Y- G�'f
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm _ Phone No.;—>u� 3e) 61
Address of Firm 2 � 1 � Zip Code
Location of proposed work
Describe fully nature of permit requested /ash 2-- 7ma6� _�;�, �!-�,�- '4M
Starting date 3— Approx.time for completion
Call Before You Dig No. /(ems`2 Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est. Patch Sizes) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
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 PE MIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLINE I OWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: 41 -e='2
Title: 6 2 0 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
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