HomeMy WebLinkAboutStreet Cut Permit 54 Andreis Trail 1000007 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER � — STREET CUT PERMIT
lool
DATE: 01/12/10 j
GIS ID: 03300054 s y FEE: 25.00
MUNIS APPLICATION# 201000026 tea; a RATION DATE: 01/12/11
�< �Z v
APPLICAN 44, LOCATION
NAME: CABLE CONSTRUCT
ADDRESS: P O BOX 159 = S =';� D IS TRAIL
O' � MICHAEL B&TAMMY A
MIDDLEFIELD,CT 0 4IS TRAIL
r`- E = OJ. INDSOR,CT 06074
PHONE 860-649-8217 h
LIT flut
s
WORK DESCRIPTION: HAN TL �
APPLICANT AGREES TO FURNISH THE T ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY I U H AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE I 1I- ,F LL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS.OUTLINED IN THE TOWN OF S UT IT MANUAL.
-VV_�_
ISSUED BY DATE INSPECTED INSPECTED BY
1/12/20109:22AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
jr
O
Pox
ma 's
laggaar,-
Aw
va " =
sAcx
, � "'
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I'Q 7 CONTRACTOR:
LOCATION:
TYPE OF WORK: Q Tp�
DATE INSP NEEDED: DATE INSP: 3f461 to
INSPECTED BY: Z
WORK IN
PROGRESS:_ a� �C
4CL"`�-_z 4T i'T Z-,
c Jed
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
901000c)(n APPLICATION FOR STREET EXCAVATION PERMIT ®r �7
Appi. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE`$25.00
Name of Firm C 5 t qt ,* r L'. Phone No.
Address of Firm k r / Zip Code S-
Location of proposed work ret i
Describe fully nature of permit requested ( c/ e e
Starting date X 0 Approx.time for completion
Call Before You Dig No. 9-0620M03-AG
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENTPATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
0
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ fft
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.
1 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.
//���I �4
Signed:A) t Date: 'l``f/y
Title: P Im Driver's License M 69.3_6 V LIO
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08