HomeMy WebLinkAboutStreet Cut Permit 105 High Street 1000202 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/23/10 p = =
GIS ID:42000105 Al
25.00
MUNIS APPLICATION# 201001288 _J/l 1vIRATION DATE: 09/23/11
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APPLICAN
LOCATION
NAME: CENTRAL SEALING RE 10-HIGt4 STREET
ADDRESS: 150 SUNSET RIDGE] y � ( J ALAN M&MARILYN P
EAST HARTFORD,CAI' 10 -J� 7 - STREET
�_ 0
? JT-4v INDSOR CT 06074
PHONE _ '
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WORK DESCRIPTION: REM V , E V p-ITH EXTENSION
TO LET SID A "
APPLICANT AGREES TO FURNISH THE T )F Sd AM 1`6 —ND REQUIRED AND TO REIMBURSE
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THE TOWN OF SOUTH WINDSOR FOR A,1 XP C = - Id11A1NTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE LPL""vv_ tea 1 p, -
v VL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SkQ-TtU ,IL�SI2ST$ETF`II3'1IIIT MANUAL.
ISSUED BY DATE SP CTED INSPECTED BY
9/23/201011:02AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1000620a- CONTRACTOR: (f&nl _1 SPa,I/�9
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:A, 10 11
INSPECTED BY: bn
WORK IN
PROGRESS: j a)h- awN ]Y\d0.0uA _ml o
-1114
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C'N`- DATE:
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
D10 4 y U 1 APPLICATION FOR STREET EXCAVATION PE. MIT �ObOo2Oa
AppL No. TOWN OF SOUTH WINDSOR Permit Na.
PUBLIC WORKS DEPARTMENT
TOWN HALE.
1640 SULLWAN AVENUE
SOUTH WIND80P.,CT 06074
FEE $25.00
Flame[f Firm C -� Sect� CD 1 VlL rPhono No. �.a 8q-� DO
Address of Firm S U.V!c,� 0 Ve— Eo§F ff5Efj�?, C7— zip Coda L4! (I Y
Location of proposed wort; se t.l? Uj I I teg -
€?escribe fdly mature of permit requested 42 f jZ0r'e e'S i Gl2 Ot Ire v� J
wt e - (6),) jo h ,`de o E 've
Staritrtg date O Approx.time fix comp ion l W e*—
Cali Before You Dig No. 39-0 0 Lf 3�v
PLEASE NOTE* THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
'PRELIMINARY€STIWIATE. THE APPLICANT IS RESPONSIBLE FOR THI~FULL FINAL.COST OF THE
PERMANENT PATCH AND CURB OEPLACEMENT,INCLUDING A14Y INCREASES IN-PATCIf AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or famish This seotaian to be frlfed out by
two copies of separate drawing indicate i+i4rtb Taytit of South Wstsdsor
No.cuts
Est.Patch Size{s) sf
Est.Pvt.MWmess In.
7
eX t Sf'l" Est.Patch Unft Price$ fsf
acQdl n'm-� 9/W Est Pam Cost
fi, :Grx �fo�X IS
d�e �.CurbRetia�mert
�
y10+ Est_Curb Unit Price$ tft
Est Curb Cost
` Est.Tmffic Ord Cost /hr
5 l)G1�k Est.Traffic Cowat S
G��t'1' ( lo'K a Amt.of Deposit$
Total Due
( )Cash ( )Check#
Applicant is resporWsibie for contacffng raid By
fhe PGRce Dept.and C.S.Y.D. .
i AGREE To FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND To REIMBURSE THE
TOWW 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
PERiVifTS—Ag OUTLINEDP THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
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. Tale• 667P �'y - - Driver*s uoense M I Ll U 3,0'P -
PERMIT$HALL BE KEPT ON JOSSITE AT ALL TMES
'weafbocmu ri Permit Go =