HomeMy WebLinkAboutstreet cut permit 318 Felt Road Ei
. ter,
900126 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/25/09
GIS ID: 32400318 ' . .r EY «.
<: FEE: 25.00
MUNIS APPLICATION �.• .''# 200901163 a
s' ':s ` PIRATION DATE:
09/25/10
PPLICAb,TT
::.LOCATION
NAME: FOLSOM CONSTRUCI�TI L 'n � �8IF
.ROAD
ADDRESS: 138 RYE STREET
Y OJNET� C`rR T E AINE D
SOUTH WINDSOR,C 4674 �x'' � 's# FTOAD
z SOUTH':'jMSOR,CT 06074
PHONE 860-528-8928 7 {
g
WORK DESCRIPTION: INST?AI
APPLICANT A »". • :`F:>-< :: .::.:- z..<:<;;
AGREES TO FURNISH THE I OW I OF SCUT p C R'a, AMOUNT QF$16ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANIx•:E PENSLS INCO R" BY TF E 1 O FQR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE'A'PL.CA'-NT fS FA3 UE&kAV,lTm AND,WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SO7mISR`S S,TEE BUT PI RMIT MANUAL.
10
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SSU BY DATE SPECTED INSPECTED BY
9/25/20092:32PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: ? L> d- CONTRACTOR: F-D 6om
LOCATION:
TYPE OF WORK: 1 Vl S't `l ( cl eco
DATE INSP NEEDED: DATE INSP: 3d
INSPECTED BY:
WORK IN i
PROGRESS:_` C�`�c �e �` - Pl�-y►
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: G tv\— DATE:
Sc AMNNLU
W/2007 Town of South Windsor INPSEMON REPORT 07
0q 3 APPLICATION FOR STREET EXCAVATION PERMIT 9 00� .
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT ,-� r
1540 SULLIVAN AVENUE Date:_L /c
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm T1_^ Phone No. ��j` 5-
Z
Address of Firm 13, s�r�� s Zip Code G 6 o"? y
Location of proposed work—f X Fe C e<�
Describe fully nature of permit requested ,� s%-t,l Si :5�'e
Starting date_ `'i �L ��d�'J Approx.time for completion
Call Before You Dig No. Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST.OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS.THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
.Show sketch of proposed work or furnish
two copies of separate drawing This section to be filled out by
Indicate North Town of.South Windsor
No.cuts
Est.Patch Size(s) sf
C-) S Est'Pvt..Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$. /It
Est.Curb.Cost$
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.
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.
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 08 REV 10-22-08