HomeMy WebLinkAboutStreet Cut Permit 97 Sally Drive 1000108 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/24/10 /
GIS ID: 79500097 �yf ��
MUNIS APPLICATION# 201000774 � � FEE: 25.00
RATION DATE: 06/24/11
APPLICAN'f  LOCATION
NAME: AIROLDI'S INC. %g SALLY'DRIVE
ADDRESS: P O BOX 71 rj �tM AO JOSE O do SUSAN V
SOUTH WINDSOR, So
_ ALL?DRIVE
VT�V IINDSOR,CT 06074
PHONE
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WORK DESCRIPTION: DRIV
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APPLICANT AGREES TO FURNISH THE T( F SO TII) S_ � T ��ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANIXP-1LS ICI F1 AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THEM AT1�I � i L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OFTSTID �LL1P IT MANUAL.
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ISSUED BY DATE INSPECTED INSPECTED BY
6/24/20109:19AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH'WINDSOR INSPECTION REPORT
PERMIT NO.: / CONTRACTOR:,
LOCATION: Is5o l PC
TYPE OF WORK: U-e Cx-ro-
CD
DATE INSP NEEDED: DATE INSP: t(
INSPECTED BY: '�
WORK IN
PROGRESS: 4vt WkA 4K�
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: . G AA—- DATE:
W12007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT �og
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: 16 vO
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm �����-, s �-+��• Phone No.
Address of Firm Zip Code
Location of proposed work 0\1-)
Describe fully nature of permit requested
Starting date Approx.time for completion \o
Call Before You Dig No. Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT 1S A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est. Patch Size(s) sf
fig• �� .3�. Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
�8 Est. Curb Unit Price
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police Dept.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
PERMIT OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date:
Title: 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 REV 10-22-08
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