HomeMy WebLinkAboutStreet Cut Permit 354 Niederwerfer Road 1000128 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 07/15/10
GIS ID: 63600528
MUNIS APPLICATION# 201000893 FEE: 25.00
TION DATE: 07/15/11
APPLICAN
NAME: BURKE WILLIAM OCATION
ADDRESS: 354 NIEDERWERFE RWER: ROAD w 11)lg rn
S WINDSOR,CT 060Lft2
°RWERFER RD
PHONE WWI .�'
DSOR,CT 06074
WORK DESCRIPTION: DRIV
APPLICANT AGREES TO FURNISH THE TO _
THE TOWN OF SOUTH WINDSOR FOR ANY Y E ND REQUIRED AND TO REIMBURSE
CONNECTION WITH THIS PERMIT AND THE Q MAINTENANCE OR REPAIR WORK IN
FOR PERMITS AS OUTLINED IN THE TOWN OF SO LL ABIDE BY THE RULES AND REGULATIONS
S T IT MANUAL.
ISSUED BY DA T E i v SPEC T 1✓D INSPECTED BY
8/6/20103:42PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
- .... -..._..._ - .-.._--- ------------ --------
TOWN OF SOUTH WINDSOR INSPECTION.REPORT
PERMIT NO,: 1 DvOJd CONTRACTOR:
LOCATION:__gay~ 5-70 A i ec�e,rwe e2
TYPE OF WORK: 17t` \Y�e
DATE INSP NEEDED:
DATE INSP:
INSPECTED BY: G D
WORK IN
PROGRESS: « L� s7r�,e '�►h�S S l,04
SEPTIC TALK PUMPED, SMASHED, FILLED WITNESSED YES [❑ NO
AS-BUILT:
INPUT:- DATE:__
W/2007 Town of South Windsor INPSECTION REPORT 07
a0100g 9 3 APPLICATION FOR STREET EXCAVATION PERMIT -
Appl. No. TOWN OF SOUTH WINDSOR TPermit No.
PUBLIC 1640 SULLIVAN AVENUE Date: V 2670/D
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm l� �� 4 �jv,rlc2 bo - � � 3 00
Phone No.
Address of Firm S'q :� er f�2 tc Zip Code
Location of proposed work 2Q h $ -'� p A\r r f tL,�f-V r R
Describe fully nature of permit requested _ r 3 q \ Acce s S ire tea y
Starting date t?!0 Approx.time for completion
Call Before You Dig-No. �� of Existing Water Supply: ❑Public Water El Well
Existing Sewage Service: ❑PubGc 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 OOST.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
two 'es of separate drawing This section to be filled out by
Indicate.North Town of South Windsor
No.cuts
`.
Est.Patch Sizes) sf
15
Est.-Pvt..Thickness- in.
j Est.Patch Unit Price$ /sf
Est.Patch Cost s
Est.Curb Replacement ft
Est.Curb Unit Price$. /ft
4- - Est.Curb:Cost f
V Est.Traffic Unit.Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting Paid B
the Police .and C.B.Y.D. y
1 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 D IN THE TOWN F`SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed:
Date: / (/�� 9
Title: n lj Yr,-yr Driver's License M 0S kD S(� T /
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