HomeMy WebLinkAboutStreet Cut Permit 09609999 Benedict Driv (2) 1000140 TOWN OF SOUTH, WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/30/10
GIS ID: 9609999 FEE: 25.00
MUNIS APPLICATION# 201000968 E '.IRATION DATE: 07/30/11
APPLICANT LOCATION
NAME: BARBER UTILITIESADDRESS: .,; BENEDTCT DRIVE
ADDRESS: P O BOX 331 OWNER TOWN OF SOUTH WINDSOR
ELLINGTON,CT 06029 1540 SULLIVAN AVE
SOUTH WINDSOR,CT 06074
PHONE 860-872-2330
WORK DESCRIPTION: INSTALI $INCH.DTP WATER MAIN•PHASE I SECTION 2
BENEDICT DRIVE"AND RAYNION,ID ROAD;
APPLICANT AGREES TO FURNISH THE TOWN OF'SOUTH:VMSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE T ,WN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANTlS FAM3 IAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSR'S,STREET CUT PERMIT MANUAL.
FEIZIJA
ISSUED BY DATE INSPECTED INSPECTED BY
7/30/20104:08PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
z
s '
r
i
TOWN OF SOUTH WINDSOR INSPECTION:REPORT
PERMIT NO.: Wo _V o CONTRACTOR: N//��hf c
LOCATION
TYPE OF WORK: 11/15` II �/� � ; �]Qin � .mSQcVi6n
DATE INSP NEEDED:_____ DATE INSP: I/ io
INSPECTED BY:
WORK IN
PROGRESS_ �i --f'
r, M `M(h.7 02 ck
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
W12007 Town of South Windsor INPSECTION REPORT 07
4C>0 = APPLICATION FOR STREET EXCAVATION PERMIT L 2 20 f,
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:_ -,
SOUTH WINDSOR,CT 06074
46c6i-114 FEE $25.00
Name of Firm_ 3W LGC Phone No. 5�00 `97 Z--253D
Address of Firm '3S' i�/N>� ®c 1 G Lb Zip Code ®Coo 211
Location of proposed work ` Cvici- '-P�L,. -OA& p V�V_Aj '� S Pa0Cr'-_ maw p i V,
Describe fully nature of permit requested_W,5-,777ZL, 6%�sz, -4//00
I AJ 0 16r 6_ . G elu 2-
Starting date Z- /oAll Approx.time for completion Z tXaA 7Y/5-
Call Before You Dig-No. 201! ` do 11180 Existing Water Supply: ❑Public Water ❑Well
z'`q i0 '30 0 15 03 Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE.DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST.OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS.THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish
two copies of separate drawing This section to be filled out by
Indicate.North Town of.South Windsor
No.cuts
at.Patch Sizes) sf
C� Y i Est Pvt..Thickness in.
Est.Patch Unit Price$ /sf
/ /11f% Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$. /ft
Est.Curb.Cost S
Est.Traffic Unit Cost /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police Dept.and C.S.Y.D.
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
TOWN OF SOUTH.WINDSO R ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION TH THIS P R IT AND THAT i AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS IN 0 IN. TOWN OF
`SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: -7� 36 -/0
Title: ®�� � /i�2 Driver's License#: 0��1 ZZZS�
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