HomeMy WebLinkAboutStreet Cut Permit 56 Berle Road 1000077 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/11/10
GIS ID: 10200056 FEE: 25.00
MUNIS APPLICATION# 201000539 EXPIRATION DATE: OS/11/11
APPLICANT LOCATION
NAME: TELE-NETWORKS ADDRESS: 56 BERLE ROAD
ADDRESS: 31 BAKEWELL COURT OWNER: LERZ MICHELLE A&
CRASTON,RI 02921
56 BERLE ROAD
SOUTH WINDSOR,CT 06074
PHONE 401-461-8420
WORK DESCRIPTION: REPT.ACE EXISTING CATV
APPLICANT AGREES TO FURNISH THE TOWN:OFSOUTH WINI?SOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPENSES'INCUR- BY THE TOWN FOR.MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAM, ILIAR.WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WNDSR'S STREIT CITT PERMIT MANUAL.
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ISSUED BY DATE INSPECTED INSPECTED BY
5/1 1/20 1 0 9:50AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /(90()07'7 CONTRACTOR: te��'
LOCATION:_ �� (p p-er ( 0 V
TYPE OF WORK: Wece. G 19`1
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: f��
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES [-] NO
AS-BUILT:
INPUT: Cam- DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
a b)DooJ r APPLICATION FOR STREET EXCAVATION PERMIT i 0006)
Appl:.No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date- 5 -('b ^UG
SOUTH`WINDSOR,CT06074
FEE $25.Q0
Name of Firm IEe- NE'kVC'' 5 Phone No. `s` 232.
Address of Firm S >: GO CC C GInS o Zip Code U Z q 2 t
Location of proposed work '�;(k
Describe fully nature of permit requested Ce�UkCe 6\ =c y
Starting date `I Approx.time for completion 5- i t;-t C)
Call Before You Dig, Existing Water Supply: ❑Public Water ❑well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH-AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,',INCLUDINC ANY-INCREASES IN-PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS.- THE PERMANENT:PATCH IS TYPICALLY
COMPLETED WITHIN A,YEAR OF THE TEMPORARY PATCH BUT iT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled but by
two copies of separate drawing Indicate North. Town of South Windsor
aeNo-guts
Est Patch Size(sj sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
.Est.Patch Cost$;
Est.Curb Replacement ft
Est:Curb Unit Price$ !ft
Est Curb Cost$
Est:Traffic Unit Cost$ !hr
Est.Traffic Controt$
Amt.of Deposit$
Total Duet
( }`Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police Dept.and.Ci13.Y.D.
U AGREE TO FURNISH TO THE TOWN OF SOUTHWINDSOR THE AMOUNT OF BOND REQUIRED,AND TO REIMBURSE THE
TOWN OF SOUTH Vt/INDSOR FOR ANY.EXPENSES INCURRED BY THE TOWN FOR:MAINTENANCE DR.`:REPAIR:WORK IN
CONNECTIO -WITH TiiIS PERMIT AND THAT I AM:FAMILIAR{NiTH AND WILL ABIDE BY THE fiULES AND'REGULItTfONS FOR
PER A 0UTLt D THE TOVITN OF.:SOUTH WfNDSOR`S STREET GUT P€KNIT MANUAL
igned' Y Date: lQ _
tie: Drivees License#:
PLEASE ALLOW AT LEAST'IWO WORKING DAYS AFTER APPLICATION FORlSSUANCE OF PERMIT
WORK;MAY NOT BEGIN UNTiLA PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON_JOBSITE AT ALL TIMES
Street Excavation Permit O8 REV 10=22-W -
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