HomeMy WebLinkAboutStreet Cut Permit 36609999 Gorski Drive 900089 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PE
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DATE: 07/15/09 uuov�v�vu�Pv ,,,gg% '%N
GIS ID:36609999 ��u°Jv vv� Vv �u��oo-nvu� uvv� avuv vvu vyv�. A\��
vow a � � � !� � �� � �v u� v ��\\\� FEE: 25.00
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MUNIS APPLICATION# 200900823 �v�v��a` °`v�� �4" V��vv�`\
a\� o�° \� \h\\\ ;E \ TION DATE: 07/15/10
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APPLICANT �n�� �� ��v\v w wv v vvv v � y LOCATION
NAME: TELE—NETWORKS a�s� a\� aa��S a \ RIVE
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ADDRESS: 31 BAKEWELL COU 2 �������^` vv, a �,v\� R�� T O; SOUTH WINDSOR
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F A � Hv�V�\uwv \��w �� R CT 060742734
PHONE 401-461-8420 �u�\ V �v� �
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WORK DESCRIPTION: REPL ING
01
APPLICANT AGREES TO FURNISH THE TO IMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANYp " E WORK IN
CONNECTION WITH THIS PERMIT AND THE AP CI I LL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SO S F" C �HERMIT MANUAL.
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ISSUED BY
DATE INSPECTED INSPECTED BY
7/15/20092:44PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:�OdO CONTRA
LOCATION:___�r7`(,S \ ^�
r&E OF WORK:_ �U G-e
—_--- --DATE INSP NEEDED: DATE
- . - INSPEGi-ED BY:
WORK IN
PROGRESS:
AS-BUILT:
INPUT: DATE:SCANNED
W/2007 Town of South Windsor INMEMON REPORT 07
SOUTH WINDSOR,CT 06074
FEE $25.00 366<1V 9
Name of Firm e' 'e CL S Phone No.
Address of Firm 3 Wt'U CT CCNI S-�b n 1 Zip Code G 3��2
Location of proposed work
Describe fully nature of permit requested VA A V
Starting date C Approx.time for completion Ac'
Call Before You Dig No.Q6Q9 IS6 �)3q- Existing Water Supply: [Wublic Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing + Indcate.North Town of South Windsor
SNo.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ !sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ At
Est.Curb Cost-$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
SCANNED ( )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
PER SO N IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
S/ i9 ned: j&^-< Date
�F 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
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TAP VALUE
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town mower and damage deep underground gG6 Q
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