HomeMy WebLinkAboutStreet Cut public utility 178 Smith Stre 1000112 TOWN OF SOUTH WINDSOR CT
PERMIT NUMBER
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W STREET CUT PUBLIC UTILITY
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DATE: 07/08/10 0\\� N\ \Nmr\
GIS ID: 83700178 "v�NNO+nW ' ovuv vvn,NVNN,nvmvNNv "vNnvv vN,vnv�WVW N%"\vtiwly\��
MUS APPLICATION# 201000845 +"0v0v�+wvnv���,A� � ���v"��`�vv'vv„wN �� `wv v "vyvvva� v �nvvanyyw , FEE:
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APPLICAN u; ,
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NAME: YANKEE GAS �� w�v� ��v° r N ` ���°�\\� a�``v��" \ OCATION
ADDRESS: 112 PROSPECT HILL W�N� �� ��� �, ,s"' STREET
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EAST WINDSOR,CT \8�8 `\\\\\\\I°"" `\1 ,�\\\��n\ \\\\\ p': `\ R.��\ \\\\ O \\ RTIES LLC
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860-292-2242 \ ��m\\\\�b '\ \ \\ Q�\�\ \��b �� � � �H\ SGK�CT 06074
WORK DESCRIPTION: INST
178
APPLICANT AGREES TO FURNISH THE TO Nal� �� "��\ + �\ �"'` "
THE TOWN OF SOUTH WINDSOR FOR ANY E � �' $ p� OND REQUIRED AND TO REIMBURSE
CONNECTION WITH THIS PERMIT AND THE AP " V— MAINTENANCE OR REPAIR WORK IN
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FOR PERMITS AS OUTLINED IN THE TOWN OF SO LL ABIDE BY THE RULES AND REGULATIONS
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ISSUED BY
DATE INSPECTED INSPECTED BY
7/8/2010129PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 7 c6o//",— CONTRACTOR: Ycc r k11z
LOCATION: I S1m See
TYPE OF WORK: 1 V1SI-a l ( q as -ty 1 ce�S 17 °}" l a 5 Y7'lY�,
DATE INSP NEEDED: DATE INSP: �3a
INSPECTED BY: Btu
WORK IN
PROGRESS: o SICe� cIn
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED YES ❑ NO
AS-BUILT:
INPUT: DATE:_
W/2007 Town of South Windsor INPSEMON REPORT 07
07/08/2010 THU 12: 58 FAX 860 292 2202 0002/002
201000845' APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
46063,06 FEE $25.00
Name of Firm C., Lhs Ph ne No. C�
Address of Firm �IS t t"} P Zip Code a(4�Qs�p
Location of proposed work
Describe fully nature of permit requested M.T kt-4 C c ` —5•P m y 5
Starting date Approx.time for completion-
Call Before You Dig No.20 I l� l. utv Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
.. .�ENG�'N;'FRAfFI' C-CONTR{�L-•-ANfI-THET�WN'SCONTRACI'C4S�'Sr THE•REfl�ANENT PATCH ISTYPiCrALLY
COMPLETED WITHIN-A YEAR OF THE TEMPORARY PATCH BUT IT COULD•BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Size(s) at
Est.Pvt:Thickness in.
t F � Est.Patch Unit Price$ (sf
a
Est.Patch Cost$
P
i Est.Curb Replacement ft
r Est.Curb Unit Price$ /ft
�•��J"1"itr7e, � #
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
�e Est.Traffic Control$
Amt.of Deposit$
Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting. Paid By
the Police De t.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-1 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS UTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
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Signed: Date: '/ O
Title: Driver's License#:
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PI+RMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08