HomeMy WebLinkAboutStreet Cut Permit 284 Quarry Brook Drive 1000178 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
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DATE: 08/31/10 �
GIS ID:74100284
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MUNIS APPLICATION# 201001143 Jam_ � FEE: 25.00
4 IRATION DATE: 08/31/11
APPLICAN LOCATION
NAME: AIROLDI'S INC. _ RED V 24 QUtRRY BROOK DRIVE
ADDRESS: P O BOX 71 ' N THOMAS P&SUS AN E
SOUTH WINDSOR, I'�04 r �% QIJAtRY BROOK DR
PHONE �OJ�VINDSOR,CT 06074
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WORK DESCRIPTION: DRIVE _ = ' if
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APPLICANT AGREES TO FURNISH THE T W O JTH AMA- O REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANI P� CLf ��IIrD �jAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THEAAIIA� _: A �yL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF 96&, I €DS T F Pt IT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
8/31/20108:49AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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APPLICATION FOR STREET EXCAVATION PERMIT OlOi
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
�(�. S 1 NC
Name of Firm '"� Phone No:
Address of Firm' Qom rl �ov�� � .s a�` Zip Code
Location of proposed work .8 ' - QvQ��� Q��o\Z �•_
Describe fully nature of permit requested �A\�� �
Starting date �` 1 �.►��,
Approx.time for completion �
Call Before You Dig No. `moo 6-3 Existing Water Supply: El Public Water Well
Existing Sewage Service: Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING`ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.7raffic Control$
Amt.of Deposit$
Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police Dept.and C.B.Y.D.
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 MTLI.NED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: _ Date: 'aS 1 d
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,`
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I C7bo 17 CONTRACTOR: 14I Gz J
LOCATION: a? J ( /1
TYPE OF WORK: bc I V wag
DATE INSP NEEDED: DATE INSP: 1 ,11911t
INSPECTED BY: J
WORK IN
PROGRESS: Look, 1�-
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C DATE:
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION