HomeMy WebLinkAboutStreet Cut Permit 280 Diane Drive 1000096
TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/02/10 % 10
GIS ID: 28200280
MUNIS APPLICATION# 201000653
FEE: 25.00
� RATION DATE:
I3 06/02/11
APPLICANT js
_ LOCATION
NAME: CENTRAL SEALINGT 2 0 DIATE DRIVE
ADDRESS: 150 SUNSET RIDGE VFfp "
r SKI DAMES E&SHARON M
EAST HARTFORD, qT 1 $ 4 DIA 1E DRIVE
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INDSOR,CT 06074
PHONE sNO
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WORK DESCRIPTION: DRI� 4
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APPLICANT AGREES TO FURNISH THE TVV�P ($JJ � q-&jND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN'Y'-- �C, F Tl -MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE P I A - L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF U" --T �� � - T�E15 -P IT MANUAL.
ISSUED BY DA INSPECTED INSPECTED BY
6/2/201010:24AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:�O� �� CONTRACTOR:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: �
WORK IN
PROGRESS: DV
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: c DATE:_ /- >6 1
W12007 Town of South Windsor INPSEMON REPORT:07
aolo 00K3 APPLICAMON FOR STREET EXCAVATION PERMIT
App,.No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL.
1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25.00
VVICa te"e " eet Name ✓ Phone N
Address of Finn _—,:AA nkj IM V4- S Zip C6&-- I is
Location of proposed work � �Ca& MY1"YG
Describe ftAly nature of permit requested rPrD avQ S re2(ace
Starting date I t vie as Approx.time for compietian PGt S
Calf Before You Dig No.
PLEASE NOTE; THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE, THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN'PATCtf AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWNS CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furrish 2e00 to be feted out bst
two copies of separate drawing Inckate Nwth Im of Booth 1IIflredscr
No.cuts
Est.Patch Sfze(s} sf
Est.Pvt.Thickness Irt.
Est.Patch Unk Price$ ----.-tsf
0
Est.Patch Cost
14, XZD Est.Curb Repent ft
Est.Curb unit Price$ -_--fit
Est.Curb Cost$
Est.Trafc Und Cost$ 1hr
Est.Traffic Control S
Amt.of Deposit$
re Total Due$
( )Cash ( )Check#
Appifcartt is resperrbie#or cbrttacting Paid By
Etta Poiic�DS t.attci C.B.Y.D. .
I AGREE To FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE T14E
TOWN OF SOUTH WINDSOR FOR ANY EXPENSES-INCURRED BY THE TOWN FOR-MAINTENANCE OR REPAIR WORK IN
coNNECVON WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
EMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'$STREET CUT PERMIT MANUAL.
Sign
Tlffe "v' Driver`sUcense#: oaf
PERMIT SHALL BE KEPT ON J€3BSITE AT ALL TUNS
Excavatim Permit 08 -