HomeMy WebLinkAboutStreet Cut public utility 815 Avery Stre 1000142 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 08/04/10
GIS ID:06300815 � e FEE: 00
MUNIS APPLICATION# 201000986 z
RATION DATE:
APPLICAN LOCATION
NAME: YANKEE GAS
S g1V Y STREET
ADDRESS: 112 PROSPECT HIL
EDWARD A&PATRICIA A
EAST WINDSOR,C "8 Y STREET
H . INDSOR CT 80 2
PHONE 860-292-2242 spa I '
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WORK DESCRIPTION: INSTlo
A
APPLICANT AGREES TO FURNISH THE TM -
THE TOWN OF SOUTH WINDSOR FOR ANY ND REQUIRED AND TO REIMBURSE
O AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE L _ ID LL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S S L1T IT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
8/4/20109:23AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** y
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /C 00/ (-/
LOCATION:
TYPE OF WORK;
DATE INSP NEEDED:;__
DATE INSP:
INSPECTED BY: BZ-
WORK IN
PROGRESS: -4 f5
SEPTIC TANK PUMPED, SMASHED, FILLED
WITNESSED El YES ❑ NO
AS-BUILT.-
INPUT: DAT 1 �E.
W12007 Town of south Windsor INPSECnoN REPORT 07
08/04/2010 WED 6: 44 FAX 860 292 2202 0002/002
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm �an v,n�f- Go—s Phone No. 8)(0 a`c;_�9 Q= �-
Address of Firm I 1,�- e C.'E +AM - Zip Code_( Cca���
Location of proposed work 81 �f
Describe fully nature of permit requested ) CAL U
Starting date Al C0 10 Approx.time for completion_ (Z"
Call Before You Dig No. 103--10.1 305 Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CUR13 REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN-PATCH AREA,CURB
L.ENGTfi,T-AAFFIGCCINTRGL-AND THE TOWN'S WNTin-AC-T COSTS:-THE-PERMANENT-PATCH-i*S TYPICALLY
COMPLETED WITHIN=A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
" 15 �f��OS ec� No.cuts
YL$ Est.Patch Size(s) sf
Est.Pvt:Thickness in.
i Est.Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement It
Est.Curb Unit Price$ /ft
t Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
O Cash ( }Check#
Applicant is responsible for contacting Paid By
the Police Dent.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 A!PbTLINED
n IN�THE
`TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: IJU `.JQ Date: -f
Tit(e: 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 JOSSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08