HomeMy WebLinkAboutStreet Cut Permit 3150unk Fairview Drive 900053 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
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MUNIS APPLICATION# 200900551 vaN ,'v\ o'a �a��,\u� \ Nov A `vB�,�� 25.00
\a RATION DATE:
05/22/10
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APPLICA
NAME: TELE—NETWORKS pv'" y 1v\ m�vvvvv o�av�v
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ADDRESS: 31 BAKEWELL COff"�i�
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CRASTON,RI 029211FIl\vu�"v° vv��� uh'm�s�w A �� � E �° '� �, a SOUTH WINDSOR
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PHONE
401-461-8420 R'CT 060742734
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WORK DESCRIPTION:
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APPLICANT AGREES TO FURNISH THE TO a e�Avm ��vv ' v aG ��° sm
THE TOWN OF SOUTH WINDSOR FOR ANY vO`` OND REQUIRED AND TO REIMBURSE
CONNECTION WITH THIS PERMIT AND THEQv°� MAINTENANCE OR REPAIR WORK IN�, ae
FOR PERMITS AS OUTLINED IN THE TOWN OF SOj' Id p\SWILL ABIDE BY THE RULES AND REGULATIONS
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ISSUED BY DA E INSPECTED INSPECTED Y
5/22/20099:39AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT-NO.: 9 O 60 S CONTRACTOR:
LOCATION: f:::a"\ r U I A-0
TYPE OF WORK: 1 V)
---— --DATE INSP NEEDED: DATE INSP: 3 /2 /o
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PROGRESS: 5
AS-BUILT:
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. DATE. J-D
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit NO.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm L2 tL'- NC fuu,0C r-S Phone NoA8 2 3 a 2•
Address of Firm : l ERKeWle �'�• C��� S kb Vt t�L Zip Cade C 2a 2
Location of proposed work 1 V' W or
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Describe fully nature of permit requested" 1n Sivxk t ce ca-+v
Starting dated 5 `b Approx.time for completion
Call Before You Dig No. c30063t j!0 '1(00
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN<PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS-TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section o be filled out by
two copies of separate drawing Indicate North Town of South Windsor
see lm-oxv Eck No.cuts
Est:Patch Sizes) sf
Est.Pvt.Thickness In..
Est:Patr'Unit Price$ isf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price
Est.Curb Cost$
Est.Traffic Unit Cost$ Ihr
Est.Traffic Control$
Amt of Deposit$
Total Due$
{ )Cash ( )Check#
Applicant Is responsible for contacting inn 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 I AM FAMILIAR WITH AND WILL ABIDE BY THE.RULES AND REGULATIONSFOR
PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL:
igned Date:- to
e: Driver's License M.
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
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