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HomeMy WebLinkAboutStreet Cut public utility 9999 Nutmeg Ro 1000244 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY re DATE: 12/09/10rC y GIS ID: 65109999 � --;4 � � FEE: .00 MU NIS APPLICATION# 201001662 IRATION DATE: f APPLICAN _" LOCATION NAME: YANKEE GAS 9999 N*FMEG NUTMEG RD SO ADDRESS 112 PROSPECT HILL s; g , SOUTH WINDSOR EAST WINDSOR,CTO' 8O w,!-- 11 film �0; ' 6,SU IVAN AVE * R,CT 060742734 PHONE 860-292-2242 �j WORK DESCRIPTION: EXC O REPAIR WIRES TO ANOl�BE - s j APPLICANT AGREES O FURNISH THE T FOOT ND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR CU T' AINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THE PT L ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF IT MANUAL. ISSUED 8Y DAT INSPECTED INSPECTED BY 12/9/20103:02PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** - --- - -- - ------. -- --- ---...._._ ......................... 6o Aio- dk gp �s a ' g` TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: /food L/ / CONTRACTOR:_ �Qo LOCATION: /IJU`/1'Y4q /20e2 d 6�0 TYPE OF WORK: Cam'CAS- iwm i C 'l reb �p A ICU ode '604 DATE INSP NEEDED: DATE INSP: INSPECTED BY: WORK IN PROGRESS:._ A 3 ?C 3 0 SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES [-] NO AS-BUILT: INPUT:— DATE:. /- aY-I S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION 12/09/2010 THU 11: 59 FAX 860 292 2202 0002/004 27Q�o o 166, APPLICATION FOR STREET EXCAVATION PERMIT '1000 Appl. No. TOWN OF SOUTH WINDSOR Permit No, PUBLIC-WORKS DEPARTMENT I540 SULLIVAN AVENUE Date.. SOUTH WINDSO R,CT 06074 FEE $25.00 Name of Firrn___�=Lec i6on Phone No. -4c-la--.ag Address of Firm 2 _VU 5 - Ztp Code ©g Location of proposed work /U /1'►E © c�o bS Lt �i 9 Describe fully nature of peemit requested OV -a W1. vM C Vil .-VD OjDcd Starting date_- i 2-i 9-l Approx.time for oornplet'wn,_,,, Calf before You 0'2 b C Existing Water:Supply: []Public wht6r D-Weii Existing Sewage Ser(m: [I Public Sewer ❑Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANEW PAVEMENT PATCH AND CURB REPLACEMENT I5 A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND-CURB-RWLACF,MENT,-IN4kUtI NG-ANY1NCREASES-fN-PATOH-AREA-CUR13. "LENGTH;TRAFFIC.CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPOF#ARY PATCH BUT IT COULD BE L.ATERINAN A YEAR. Show sketch of proposed work or fumish • toThts section ta.be filled out by two copies of separate drawing i ; Indicate.' down bfuth Win.South,s2 n a" No.ruts Est.Patch Sizes} sf Est.PvL Thiic kness In. Est.Patch Unit Price$ /sf Est;Patoh-Cost$k Est.Curb Replacement—.it Est.Curb Unit Price$_ /ft Est.Curb Cast Est.Trafric Unit Cost$ /hr Est.Trafflo Control$ Amt.of Deposit$ Total Due$ { )Cash ( )Check Applicant Is responsible for contacting Paid By. the Police Dept.and C.S.Y.D. •I AQRI E TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE SDU.j I W �R Fi-P[�R +1 -E FN 4�t t ii i n Fiv-Fei T R=�A� wr' nQ to �i�iR-uiuno� �r� CONNEGTIt WITH THIS PERNT AND THAT I AM FAMILIAR-WiTti AND WILL.ABIDE:BY THE RULES AND REGULATIONS FOR PERMITS S INED IN TOWN OF SOUTH INDSOF3'S STREET CUT PERMIT MANUAL. Signed' Date,, V Tale• CbrroSiAcn Z) _ I Driver's license#: PLE-ASE ALLOW.AT-LEAST TWO-WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT WORK MAY NOT BEGIN UNTIL A PERMIT HAS SEEN ISSUED PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES 5beet Exovaft Perr 08 RB/10-22-N .. C) �D M CD Is, r o0 cc cD 00 Is 41 J. I i � � ti� r•'�� N V a it II £�pS i I � ; s f ' a Wood near aaT E 2,g The material contained on this ma shall be considered prapriMary to Tl t I e: � Yankee Gas and user(which rs cD defined as a person or en6ly h /� cD who has receivad the map through I I /• _ � � ' �' ^-� o.q w sale,purchase,exchange,gift,or !I i 11f ✓ 1/ �J o 6ttlefwiso)shal{keep It in COnf[denCe ' o and shelf not furrtish or disclose it i to any third party without the prior j 1 i Information shown is not guaranteed and Yankee Son assurnea no responalWlity. ~"'""�" Tit �1�Of IhtGS�llt6i1it5 ,rl,yf$�CM "'p written permw:on ai Yankee Gas, i l Cantroptars are urged to m,,Yankee Gas for further informaLon of I-BW-989-09ao a e: — ec�,' 107 Selden St„Berlin CT 06037 ��E i 0 i - r ki.. 1-3 CD { • co CD r � N • r N ii i r 'f*• •/V s, � 3 i a MOW i".83,3' 16T 2.4 The material contained on this inapt T!t le. •� shall be considered proprietorp to ! o Yankee Gas and user(whidt ri E 1 defined as any person or entity ; y— ('�/� who has reeaved the map through; i i fr 9 tY sale.purchase,exchange.gift: or I: {{{ f ! jJ 1 / � otherw se)shall keep it in confident t E CDand sh h not furnish or disclose it ` to any thins party without the prior I!- Infottnotion Shown is not guoro u m nteed and Xonkee Goa oamsm no reapsibiiittyy • ""' The Npr{tIC431 SJ1iIi>lilS sySlldn written permission of Yankee Go*, Cantrnetars ere urged to cell Yankee Cos for rurther information at t-800-9 - 00 ' e: 107 Sdden SL,9edin CT 06037