HomeMy WebLinkAboutStreet Cut Permit 178 Smith Street (2) 1000134 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/28/10
GIS ID: 83700178
MUNIS APPLICATION# 201000948 FEE: 25.00
= RATION DATE: 07/28/11
APPLICAN LOCATION
NAME: KF CONSTRUCTION
�MI H STREET
ADDRESS: 175 WHEELER RO = ffOERTIES LLC
SOUTH WINDSOR, LERRD
PHONE - - O INDSOR,CT 06074
WORK DESCRIPTION: INST 5
APPLICANT AGREES TO FURNISH THE T ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A C FO MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE 4TLL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S 3 S�TtUT IT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
7/28/2010 12:01 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION:REPORT
PERMIT NO.: ,
CONTRACTOR. /� r Corky-wc o
LOCATION: I�� yl
4 �y�
TYPE OF WORK; �L i?ct S/
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: 6
WORK IN
PROGRESS:_
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: e- m DATE:
W12007 Town of South Windsor INPSKTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No. 1
PUBLIC WORKS DEPARTMENT "��` Ld
1640 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm 1� ��� �'uf.��-n� Phone No. Pb—d C/
Address of Firm 1-7 Li Zip Code
Location of proposed work 1 .7
Describe fully nature of permit requested 1 0-S L
Starting date_ --Z _ Approx.time for completion
Call Before You Dig No. Existing Water Supply: ublic Water ❑Well
Existing Sewage Service: ublic Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE,FULL FINAL COST.OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
-LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS.THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing This
Town of:South Windsor
No.cuts
Est.Patch Sizes) Sf
EsL-PvL Thickness. in.
Est.Patch Unit Price, /sf
Est.Patch Cost s
Est.Curb Replacement ft
Est.Curb Unit.Price$. fit
---�, Est.Curb:Cost.$
Est.Traffic Unit Cost$ /hr
liA\ Est.Traffic Control s
Amt.of Deposit$
Total Due$
( )Cash Check#
Applicant is r ible for contacting Paid By
the Police and CA.Y.D.
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 P M T I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLI IN F`SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date:
.Title: 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 N P&10-22-08