HomeMy WebLinkAboutStreet Cut Permit 31 Andmar Lane 1000090 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/24/10 ��
GIS ID: 03000031 _��
MUNIS APPLICATION# 201000607r FEE: 25.00
�IRATION DATE: 05/24/11
'APPLICAN'
LOCATION
NAME: PAGANI CONSTRUC I LLC ANDI IAR LANE
ADDRESS: 15 KING STREET
s 1 I l ICHAEL F JR&JOANNE
VERNON ROCKVILII y 1AR LANE
�} TwVTNDSOR,CT 06074
PHONElow—
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WORK DESCRIPTION: DRIA�I�
APPLICANT AGREES TO FURNISH THE T � F` LITIAMQ ND REQUIRED AND TO REIMBURSE
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THE TOWN OF SOUTH WINDSOR FOR ANXP.1`I3S> C *IIIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TH tlrmmF�1M IAA AVL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF 90V- N DSIZ S�TI Tfi" P I IT MANUAL.
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ISSUED BY DATE INSPECTED INSPECTED BY
5/24/20109:35AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /0000 9 o CONTRACTOR: PO Ian) 1'a l'V "•
LOCATION: 3'1 ►) r1 c) en a
TYPE OF WORK: kpPGg0U
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS i <. - ,� 3 , ew L--
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: _ DATE: - l
W12007 Town of South Windsor INPSECTION REPORT 07
aol�ao�o-� APPLICATION FOR STREET EXCAVATION PERMIT �U®ad90
Appl.No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date•
SOUTH WINDSOR,CT 06074
FEE $25.00
1 N
:Name of Firm � � _ Phone No.
Address of Firm IF4C, Zip Code 0 6 O
Location of proposed work YH 3"s
Describe fully nature of per it requested k 5 e- w
rj o C s
Starting date Approx.time for completion
Call Before You Dig No. )0 -70 Existing Water Supply: BPublic Water 0 Well
Existing Sewage Service: [0 Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price
1 ` Est.Patch Cost$
1 ` ` Est.Curb Replacement ft
1 n `l Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
e Amt.of Deposit$
Ci) Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police Dept.and C.B.Y.D.
I AGRE ISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
TO OF SOUT WINDSOR FOR E NSES INCURRED BY THE TOWN FOR MAINTENANCE'OR REPAIR WORK IN
C NECTION H THIS PERMIT THA I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
P MITS T IN N O OUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: O �
Title: Driver's License#:
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT r
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES I-D Co NAB �t
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Street Excavation Permit 08 REV 10-22-08
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