HomeMy WebLinkAboutStreet Cut Permit 67 Brewster Road 1000051 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 04/07/10
GIS ID: 13200067 = FEE: 25.00
MUNIS APPLICATION# 201000344 RATION DATE: 04/07/11
APPLICAN- � , - _ -
LOCATION
NAME: AIROLDI'S INC. L
� � �. .- ` TER ROAD
ADDRESS: P O BOX 71 Q PAUL P&PAMELA J
SOUTH WINDSOR, y TER ROAD
w _ FI SOR,CT 06074
PHONE
WORK DESCRIPTION: REM
ld
APPLICANT AGREES TO FURNISH THE TO O OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE �tT LL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SO U RMIT MANUAL.
ISSU BY DATE INSPECTED INSPECTED BY
4n/201011:45AM *** PERMIT TO BE KEPT ON JOB -SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /OWS I CONTRACTOR: ► /f0 ld l
LOCATION: Ui -7 9rew15
TYPE OF WORK: . 1 <-'k
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: G)Dt
WORK IN
PROGRESS: h.,
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT loc sS1
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: L-7110
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm Phone No.
Address of Firm U Zip Code
Location of proposed work
Describe fully nature of permit requested
Starting date Y AO td Approx.time for completion
Call Before You Dig No.' —n J r a`j 1_ Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est. Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ At
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
W Amt.of Deposit$
Total Due$
( )Cash (✓Check#_I 6<2
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
PERMITS AS OU IN IN�HE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: o ),, � Date: S`
Title: t ��w� 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