HomeMy WebLinkAboutStreet Cut Permit 140 Pheasant Way 1000029 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 02/19/10
GIS ID:71100140 FEE: 25.00
MUNIS APPLICATION# 201000141 EXPIRATION DATE: 02/19/11
APPLICANTS LOCATION
NAME: CONNECTICUT CABLE;CONST` &MTC ADDRESS: 140 PHEASANT WAY
ADDRESS: P O BOX 159 OWNER: TELLER SCOTT D&BOBBI J
MIDDLEFIELD,CT 06455 140 PHEASANT WAY
SOUTH WINDSOR,CT 06074
PHONE 860-349-1807
WORK DESCRIPTION: HANG T DrG O EXPOSE TELEPHONE SPLICES FOR-AT&T 140, 146,172
PHEASANT WAY
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH.WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPEN.SES INCURRED BY'THE':TOWN,FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSR'S STREET CUT PERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
2/19/201010:39AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: / OODO a CONTRACTOR: Cl �i4 b If LO�-S�Z,
LOCATION: 0 y—� 1 7�' ✓�eV_(GI' t
TYPE OF WORK: IkI62 6
DATE INSP NEEDED: DATE INSP: -1 K
INSPECTED BY:
WORK IN
PROGRESS: w 0 r
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
W12007 Town of South Windsor INPSEMON REPORT 07
aol000 l q 1 APPLICATION FOR STREET EXCAVATION PERMIT C006a r
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm G�C�bf� Const t /• a, PA J m C . Phone No.
Address of Firm IiAc�u- f k r` Acce55 d. cl ie reJc� G Zip Code ( �/
Location of proposed vvork4eAsqA I YU ( J
Describe fully nature of permit requested HA0 �1 G 7L DoS� l col
Starting date ah Approx time for completion eC
Call Before You Dig No.
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
SEE ATFA c ffL1> 0
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement ft
fi„ �4-. Est.Curb Unit Price
C "mot J Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
C ] _ ,/ (� ` Est.Traffic Control$
G+� Lf/)Sl f Vt�J /.2 5 ��"1 V t ) o Amt.of Deposit$
Total Due$
( )Cash ( )Check#
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 OUTLINED IN THE
^TOWN
�OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: �o Date: d-/(/7[/0
Title: P1171 Driver's License M CL�3 5;�'If YO
.PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08