HomeMy WebLinkAboutStreet Cut Permit 2040unk Clark Street (2) 1000053 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 04/07/10 �au„"�aa�� ��`"�"\���1111
GIS ID:20409999
��p�p. m�q�0�a"�V�`nxm�ma��oaNnN� FEE:
MUMS APPLICATION# 201000349 25.00
��� mo�u
s� �`
��� ������ �a ��v TION DATE: 04/07/11
p�u ,q�U , V� aagm
\�� A��ao�pa pAAAA�\\V\\\V\V\na�aQu������m��V���`����
APPLICANT O� �\o�\\ \,\LOCATION
aa� ,�„�u \\v
NAME: SERTEX a� w��° ,u° ��w,, v V v\n v � \u�
m ��au \� �d r
ADDRESS: 245 WATERMAN ST0 v` ,, INDSOR TOWN OF
�, m` ARK , TREET
PROVIDENCE, �\,s��a llA �.�, \� �N\,
RI 02 On eau u �pAw°n wvo�` �p��uv0\Vu��VAjv�°V ' \�� IVAN AVE
INDSOR,CT 06074
PHONE 401-454-4102 X 102a�A
WORK DESCRIPTION: STRE,.T
� � �� � �+� CONDUIT
LOCA' DTH S I RSF TION
�� �
APPLICANT AGREES TO FURNISH THE TpF REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY E C
�,,,;�" �f ��`'�IAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S w r S
�� „ �� T IT MANUAL.
u�a ou a na�n
uua�u��wmacm����munmaavm
ISSUED BY DA INSPECTED INSPECTED BY
4/7/20101:05PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 100W'S 3 CONTRACTOR:
LOCATION: C_l lA'1 V S tree
TYPE OF WORK:—. t 7-
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS: tK
Ct4,r6 inn. l-m--n�'ae -Ell j4T CIl
-=ftvnP Palo IV7a
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: 3 I
DATE:
W12007 Town of South Windsor INPSECfION REPORT 07
aa 9 APPLICATION FOR STREET EXCAVATION PERMIT l 0000 53
Appf. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH.WINDSOR, CT 06074
FEE $25.00
Name of Firm E✓ # K LL(— Phone No. ND) -
Address of Firm n,�1a.�er,rtiav Zip Code 00,CIO6
Location of proposed work Ck6.rVC 64rte t �- iv. S4r.-,i
Describe fully nature of permit requested j ew
Starting date S Approx.time for completion S 1_o vie
Call Before You Dig No. I d D 9 a o Y 66
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts0
Est.Patch Size(s) sf
Est.Pvt.Thickness 4 f pj in.
Est.Patch Unit Price$ z'l�S /sf
��� Est.Patch Cost S 9, 15
, 1S p
Est.Curb Replacement ft
Est.Curb Unit Price$ • /ft
V Est.Curb Cost$
— � Est.Traffic Unit Cost$ /hr
��t�i?g ►�Y�ACJFi► n/ Est.Treffi.c Centro[$
65.� r
t.of Deposit$
Total Due$__ 9.27C
J
-see �f�c�Ght.� atr4w►ut� ( )Cash ( )Check# &$/
Applicant is responsible for contacting Paid By S ►^
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 I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS 7":Uee
LINED IN T TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Sign
. Date:
Title: Drivers License M
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08
c"
mill
mill gig
jai
o f a o a 9
� I
i
W
® 3 Jr
v.1 Q .
CL
oo
i
v7
RR x
; t