HomeMy WebLinkAboutStreet Cut Permit 760 Pleasant Valley Ro 1000239 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
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DATE: 12/02/10 h
GIS ID: 72900760 x =
MUNIS APPLICATION# 201001617 � FEE: 25.00
-RATION DATE: 12/02/11
APPLICAN Air � ' LOCATION
NAME: F J FIANO CONSTRU I�s T LG � RE§_ PLE SANT VALLEY ROAD
ADDRESS: 365 WEST STREET �VIEJAMES J SR&SANDRA L
BOLTON CT 06043 WaM
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-> AfffMZ4JIVINDSOR,CT 06074
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WORK DESCRIPTION: HOOlkl_ WWB
APPLICANT AGREES TO FURNISH THE TW�_ SOLTTH AMy} p REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANN� *. S ' �'Fiw � " AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE 'PLA L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF-k-O'Tif S- -I TR IT MANUAL.
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ISSUED BY DATE INS ECTED INSPECTED BY
12/2/20102:43PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:_ob2_cAa7 CONTRACTOR: FT vq n Q
LOCATION: (p dSan
TYPE OF WORK: �p
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DATE INSP NEEDED: DATE INSP: /2 //o /
INSPECTED BY:- Q p
WORK IN
PROGRESS: ���►I-z-���,. C®.�,<< �c� G '' �'yy� S D 2
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1640 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm o Phone No.
Address of Firm s Zip Cod
Location of proposed work
Describe fully nature of permit requested
Starting date /d Approx.time for completion
Call Before You Dig No. Existing Water Supply: ❑Public Water EfWell
Existing Sewage Service: ®"Public Sewer ❑Septic
PLEASE NOTE:. THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate.North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Ungt Price$ !sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$ ��
(6ash ( )Check#
Applicant is responsible for contacting Paid By
the Police Dept.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 I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OIJ QED IN THE XOW SO WINDSOR'S STREET CUT PERMIT MANUAL.
Sig /fl 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
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PROPOSAL
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Proposal Submitted To: Work To Be Performed At:
Name ( �� �'1 Lot#
Street b� Cq�, C rdl`T' kctll e y i�� Street
City L c State City �!K'o 4 State
Phone-060) Sa S(.& 13 �[
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ea�C�A
CT Sales Tax Will Be Added , 'r
Date Work Completed
Date Paid Check#
lly Submitted Per
Deposit May Be Required. V\Ckx czaer
Few, t1
Note:This proposal may be withdrawn by us if not accepted within 30 days.
ACCEPTANCE OF PROPOSAL
The above prices,specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work as specified.Payment will be
made as outlined above.When proposal is accepted,please sign and return white copy.
Date: Signature
Molloy, Catherine
From: CallCenter@CBYD2.com
Posted At: Monday, November 29, 2010 4:10 PM
Conversation: Locate Request-20104900987
Posted To: CBYD
Subject: Locate Request-20104900987
(CALL BEFORE YOU DIG - CT) 11/29/2010 16:10:11
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***** ROUTINE *****
TIME. .16:10 DATE. .11/29/2010
REQUEST NO. . .20104900987
LATITUDE. .41.8124980 LONGITUDE. .-72.5893771
TOWN. . . . . .SOUTH WINDSOR
ADDRESS. . .760
STREET. . . .PLEASANT VALLEY RD
NEAREST
CROSS STREET. .LONG HILL RD
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TYPE OF WORK. . . . .EXC TO INSTALL DRAINAGE
AREA IS MARKED. . .YES
REMARKS:
WORKING FROM CATCH BASIN IN ROAD AND GOING TO REAR OF HOUSE REF SNET PL 918
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START DATE. . . . . .12/02/2010 START TIME. .07:00
CALLER. . . . . . . . . .FRANCIS FIANO
CALL BACK. . . . . . .
PHONE #. . . . . . . . .860-649-8045
FAX #. . . . . . . . . . .
ALT. PHONE #. . . .
EMAIL ADDRESS. . .
CONTRACTOR. . . . . .F J FIANO
ADDRESS. . . . . . . . .365 WEST ST
CITY. . . . . . . . . . . .BOLTON
STATE. . . . . . . . . . .CT
ZIP. . . . . . . . . . . . .06043
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EXCAVATOR DOING WORK. .SAME
ISSUED TO: DATE: TIME: BY:
DATE/TIME ARRIVED: TIME LEFT: COMPLETED BY:
CALL BACK: 1) DATE: TIME: BY: 2) DATE: TIME: BY:
PERSON CONTACTED: PERSON CONTACTED:
1