HomeMy WebLinkAboutStreet Cut public utility 56 Bramblebrae 1000039 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER ��� :, STREET CUT PUBLIC UTILITY
DATE: 03/31/10
GIS ID: 12600056 �� - s FEE: 00
MUNIS APPLICATION# 201000299
� ATION DATE:
y
APPLICAN - L OCATION
NAME: YANKEE GAS S 03M LEBRAE
ADDRESS: 112 PROSPECT HILLM, ET LINCOLN H&JANET H
EAST WINDSOR,C LEBRAE
.0lj H V INDSOR,CT 06074
PHONE 860-292-2242
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It WORK DESCRIPTION: INST& VT E . z l
t
APPLICANT AGREES TO FURNISH THE TO�OMSfI � E'��TI�IFDND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY ESO NC RBY O MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE AIS - VINIL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOlSSTPRMIT MANUAL.
ISSUED BY DATt fNSPECTED INSPECTED BY
3/31/20109:58AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
Uri I t IMF N=&U: DATE INSP:. r 2 11 I lb
INSPECTED BY: gD
WORK IN
PROGRESS; G.
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
0,p06999. APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL .
1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm �-�c c �� Phone No. -2-,0 e)
Address of Firm 442 Zip Code
Location of proposed work t aenhleh rq.
Describe fully nature of permit reques Cs-A C fyi,n dam_
Starting date :?1 -3 j %h Approx.time for completion 3/ ,/0
Call Before You Dig No._ A,&>/& 3 2-o 7
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT 1S RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
'COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of.South Windsor
No.cuts
Est:Patch Sizes) sf
Est.Pvt.Thickness in.
a
Est.Patch unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Uriit Price$. /it .
Est.Curb Cost$
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.
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 I E TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: �i'� Date: -Z9 /y
Title:_4e�� Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08.doc
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