HomeMy WebLinkAboutStreet Cut Permit 78 Sand Hill Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4311 Cont >dfor INCOR CRATED CONSTRUCTION
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Location 0078 SAND HILL ROAD $cf'clres ; �`180 :rtR::,NiWBEfRt RD
Type Work WATER ' w k K;,1,,V't"Q_03MFIRLD XT> 0'S.002-1331
1.
Date Insp Needed W 1 �. , j ..Dat-@- T'i
Time Insp Needed :�`' ^ ittl Iij " e"
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Inspected By
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Work in Progress
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Permit No. 4311 Town of South Windsor, CT
Date 10/06/2006 Street Excavation Permit
Expiration Date 10/06/2007 ` " y+
Descrip: INSTALL NEW WATER �ERVTVE a.
Ott ��:"�:� �y W,. ':.. `'��=,3k � '�:.:� �•'�`-°z, n .�s.
Applicant `:,s
Y",;iO ..•'`f?' :w :1'c,Y < ..:ti c. ^`i
Name INCORPORATED CON TRU6TI-f6 .. " SAND HII ,RO
Addr. 180 W NEWBERRY ItDi. .' 3
BLOOMFIELD CT 0 fi O, .. „z F'
VA:?-L3�lF '���;.�n� ::� ' .:�f": i;..
Phone "
(860)242-0150 -
>:33F ``.�i<�.,,Str:
Applicant agrees>; to ,skV the^T:saW4,?, F. z u Wind o y;t iexagio]ant of bond
required and torA rei biY .'se a
>. � hu �b: :aIi> xp e s e s
:a.t�i:>:. ,
incurred by the Town a '.ii'a? Yt` tea `or` Yep'air` cs to n. ctii with this
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permit and that appl3 cih�ht T.1,J4 jY" e rules and
regulations for permits a .. oittB� neet%,t.h er T d :=of Saud-i Tzt* ndsor's Street
Cut Permit Manual.
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* * PERMIT TO.BE TC� '� OIL' JOB I 'AT �bi, TIME
:
Issued b
y �Tat1
Date Completed ------ Inspected By __ _d �� �
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
_ FEE $25.00
Name of Firm �-
`� GJ r-( l i Address of Firm Phone No.—
�j t
Location of proposed work ;� <
.Describe fully nature of permit requested
Starting date � l
Call Before You Dig No. U Approx. time for completion
Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing Indicate North This section to be filled out b
Town of South'Windsor
Pavement Cut
No.cuts
79 94 nd A/V Est.Size Pe .,Patc s)
lase
Est.Pvt.Thickness _in.
Est.Unit Price
UP Amt.of Deposit$ �' �•�
Total Due$_(-� (// by
Cash(f:Check#
Permanent Patch
yr No. Cuts
Size of Patch(s)
Final Billing
5 � a/tr r►ay�
l �Xif Amt.Due Payee
�Gr
Amt.Due Town
Vf
Applicant is responsible for conta in SS"L
the Police De t.and C.B.Y.D. DatA
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 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#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
TOWN Of SOUTHWINDSOR
ENGINEERING DEPARTMENT
ADDRESS PERMIT NO. SHEET
UTILITIES OF
I SPECTOR TEMP.PATCH DATE
INSPECTOR _ COMPLETIONDATE
.z
6 �
Bernard Drabek Locate Request 20064003126 Page 1 =
From: <CaliCenter@CBYD.com>
To: <cbyd@southwindsor.org>
Date: Thu, Oct 5, 2006 4:28 PM
Subject: Locate Request-20064003126
(CALL BEFORE YOU DIG -CT) 10/05/2006 16:27:01
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*****ROUTINE*****
TIME..16:26 DATE..10/05/2006
REQUEST NO...20064003126
LATITUDE..41.8366966 LONGITUDE..-72.5548667 P -
TOWN......SOUTH WINDSOR ` {r
ADDRESS...78
STREET....SAND HILL RD
NEAREST
CROSS STREET..SULLIVAN AVE
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TYPE OF WORK.....EXC TO INST WTR SERVICE
AREA IS MARKED...YES
REMARKS:
WORKING FROM THE MAIN LC ACROSS THE ST FROM THE PROP
CROSSING THE RD AND GOING TO THE LEFT FRONT CORNER OF THE
HOUSEFOUND
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START DATE......10/11/2006 START TIME..08:00
CALLER..........CINDY SCHWEIR
CALL BACK.......8-5
PHONE#.........860-242-0150
FAX#...........860-243-3360
ALT. PHONE#....
EMAIL ADDRESS...
CONTRACTOR......INCORPORATED INDUSTRIES LLC
ADDRESS.........12 NORTHWOOD DR
CITY............BLOOMFIELD
STATE...........CT
ZIP.............06002
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EXCAVATOR DOING WORK..SAME
ISSUED TO: DATE: TIME: BY:
DATE/TIME ARRIVED: TIME LEFT: COMPLETED BY: