HomeMy WebLinkAboutStreet Cut Permit 99990600 Autumn Drive 900144 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 11/03/09
GIS ID: 99990600
MUNIS APPLICATION# 200901338 FEE: 25.00
e RATION DATE: 11/03/10
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APPLICAN LOCATION
NAME: TELE-NETWORKS .p - �
ADDRESS: 31 BAKEWELL CO ��
No SOUTH WINDSOR
CRASTON,RI 02921 0 0-au4IVAN AVE
IMSR,CT 060742734
PHONE 401-461-8420
WORK DESCRIPTION: REPL -
s
APPLICANT AGREES TO FURNISH THE T d1 ® ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY E C AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE T LL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S " �i3T = IT MANUAL.
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ISSUED BY E INSPECTED INSPECTED BY
11/3/20098:36AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: C) to y 7 CONTRACTOR:
LOCATION: ► _U,-F V rr Y1
TYPE OF WORK: n C
DATE INSP NEEDED: DATE INSP: f 201i o
INSPECTED BY
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: cW� DATE: 2'
W/2007 Town of South Windsor INPSECTION REPORT 07
APPUCAMON FQR STREET EXGAVA noN PERMIT
Appi.No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1640 SULLIVAN AVENUE Oats:
Y SOUTH WINDSOR,CT 06474
FEE $25.04
Name of Firm e� 1 �" �}� S Phone No.
Address of Firm 3 f Q f"�� T Zip(;ode f�Z 2
Location of proposed work jb1jM IQ
Describe fully nature of permit requested re-puce aviti n Gt Co,,
Starting date 10 '1 Approx.time for completion 1 ru
Call Before You Dig No. o(3 4'3 0 2 6 3 0 Existing water Supply: p IPubic Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE. THE DEPOSIT FOR THE PERMANENT'PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE-FULL FINAL COSTOF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCN-AREA,CURB
`LMQTH,TRAFFIC CONTROL AND-THE TOWNS CONTRACT COSTS.'THE PERMANENT PATCH IS TYPICALLY
COMRLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN-A YEAR.
Show ketch of proposed work or famish This section to to tilted out by
two copies of separate drawing (rdicate.Nath - Tevm of-South Windsor
No.cuts
Est.Patch Sizes) sf
Est.-Pvt.Thickness- in.
. Est.Patch Unit Price$ /sf
Est.Patch
-Cost-$
Est.Curb Replacement ft
Est.Curb Unk Price$ IFt
Est.Curb Cost-$.
Est.Traffic Unit.Cost$ /!x
Est.Traffic Control$
Amt.of Deposit$
Total Due$
O Cash O Check#
Applicant is responsible for fteling, Pad By
the Ponce Dept.and CA.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 pCPENSES`INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNEC_7LQN WITH THIS PERMIT AND THAT 1 Aki FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PER S OUTLINED IN E IN OF'11 WINUSOR'S STREET CUT PERMIT MANUAL.
igr�ed: a-- Date: ' 27 _O
te• Ddvees 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
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