HomeMy WebLinkAboutStreet Cut Permit 35 Stephanie Lane 900154 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 11/23/09 � �' � es
GIS ID: 85800035
- - FEE: 25.00
MUNIS APPLICATION# 200901433 =G --RATION DATE: 11/23/10
APPLICAN LOCATION
NAME: TELE-NETWORKS vk CEP"ANIE LANE
ADDRESS: 31 EAKEWELL COU �_ 5 L THOMAS N&
_ 4
CRASTON,RI 02921 TEPANIE LANE
OJVINDSOR CT06074
PHONE 401-461-8420 _ - '
WORK DESCRIPTION: REPL - �
0
APPLICANT AGREES TO FURNISH THE T F-� TIt ' _-
F$ ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY x H �6 AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE I L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF 5 � E - IT MANUAL.
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ISSUED BY DATE INSPECTED INSPECTED BY
11/23/200910:19AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 9 Go I Sq CONTRACTOR:
LOCATION: 3 S
TYPE OF WORK:
DATE INSP.NEEDED: DATE INSP:
INSPECTED BY: Bl!)
WORK IN
PROGRESS:_ (iwqk
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT:_(�I°� DATE: _
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT Isy
Appl.No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm _4 k - Ne. w(3c Ph
�S 5.23
one No.
Address of Firm ' S Yt Zip Code CdQ 1
Location of proposed work VV C V\If
Describe fully nature'of permit requested iC'f eCkCe /IV)P ^t CA-TV
Starting date �'2 b�C Approx.time for completion (
Cali Before You Dig-No. �i 1 Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
' PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL'FINAL COST>OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH'AREA CURB
LENGTH,TRAFFIC CONTROL AND-THE TOWN'S CONTRACT COSTS.-THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR-OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed workor furnish w This section to.be tilted out by
two cxapies of separate drawing indicate.North Town of Ssuth Windsor
No.cuts
W.Patch Size(s)_ _ sf
Est.`Pvt..Thickness- in.
Est.Patch Ur*Price /sf
Est.Patch-Cost S
Est.Curb Replacement ft.
Est:Curb Unit.Pdoe$. /ft
Est Curb:Cost Z
Est.Traffic Unit Cost /hr
Est.Traffto Control Z
Amt.of Deposit S
Total Due$
O Cash O Check#
Applicant is responsible for contacting Paid By
the Police t.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 0
U ED IN THE N OF-SOUTH WINDSOR'S STREET CUT PERMIT MANUAL
ned� Date*. L "�0� I
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 P"10-22-08
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