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HomeMy WebLinkAboutStreet Cut Permit 1 Vibert Road 900081 PENT NUMBER TOWN OF SOUTH W I N D S O R, CT DATE: 07/15/09 STREET CUT PERMIT � GIS ID:91800001 MUNIS APPLICATION# 200900814 � - - FEE: gA .00 TION DATE: 07/15/10 APPLICANTS -- . NAME: s C H NICKERSON ANDOp , . OCATION ADDRESS: 49 HAYDEN HILL RO1I gI ROAD P O BOX 808 IF s SBISOR TOWN OF 65 ff TORRINGTON,CT 069�0m s VkAD PHONE "5 � � _ s sVIVDSOR,CT 06074 £ Al WORK DESCRIPTION: INST&LAAVV&-&& AP k ION TATINM �FFI T R� ITY CONNECT APPLICANT AGREES TO FURNISH THE T( OF UT ROfT NOVA SOUTH THE TOWN OF SOUTH WINDS OR FOR ANVI , // E AM© 2 D REQUIRED AND TO REIMBURSE CONNECTION WITH THIS PERMIT AND THE PPL SIB C. E TO F MAINTENANCE OR REPAIR WORK IN FOR PERMITS AS OUTLINED IN THE TOWN OF ��'WW AIVD "ABIDE BY THE RULES AND REGULATIONS x CW by" aft � MANUAL. ISSUED BY DATE TED 7/15/200911:17AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** INSPECTED BY TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.:_aQ � CONTRACTOR: G' If /�l C rS-can V- ca LOCATION: V 1 �o TYPE OF WORK: J l) L�hf #f 1��4 jo /l'QZ --: --DATE TNSP NEEDED: DATE INSP: / 1 i INSPECTED BY: 6 WORK IN -PROGRESS: c AS-BUILT: - INPUT: �M 1 DATE: W/2007 Town of South Windsor INPSEMON REPORT 07 APPLICATION FOR STREET EXCAVATION PERMIT Appl. No. TOWN OF SOUTH WINDSOR Permit No. PUBLIC_WORKS DEPARTMENT 1540 SULLIVAN AVENUE Date: SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm G Al,', ray n� ��� Phone No. ��—D� Address of Firm D 9AK �'Dr� 7�,,.��,o,f�� c� ,� g z 9 J Zip Code Location of proposed work �►/'•/ ' Describe fully nature of permit requested r 1 , a Starting date ,9 Approx. ime for completion Call Before You Dig o. �DD9-23,E-2�o� Existing Water Supply: public Water [I Well Existing Sewage Service: 2-Public Sewer ❑Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch of proposed work or furnish This section to be filled out by two copies of separate drawing Indicate North Town of South Windsor No.cuts Est.Patch Size(s) sf Pvc C'WeV Est.Pvt.Thickness in. fie S>s-eern��ho e Est.Patch Unit Price$ /sf C)L Est.Patch Cost$ - (New)r � Est.Curb Replacement ft Est.Curb Unit Price$_ /ft Est.Curb Cost$ Est,Traffic Unit Cost$ /hr Est.Traffic Control$ AmL of Deposit$ �Q Total Due$ vk ( )Cash ( )Check# Applicant is responsible for conta� 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 ERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OU TW O UTH WINDSOR'S STREET CUT PERM!IV MAN L. Signed: Date: Driver's License#:_O444 o"7t 4—ol- 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