HomeMy WebLinkAboutStreet Cut Permit 47 Judge Lane 1000002 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
yy-= STREET
CUT PERMIT
DATE: 01/12/10zQ
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GIS ID: 48300047 - �
MUNIS APPLICATION# 201000020 FEE: 25.00
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APPLICAN �� lk
CATION
NAME: CABLE CONSTRUCT ( �` LO
ADDRESS: P O BOX 159 S1 DG�LANE
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MIDDLEFIELD,C 4 O - S`b1 ELIZABETH J
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_ y LANE
PHONE 860-649-8217 , �� OATH�1NDSOR, CT 06074
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WORK DESCRIPTION: HAND ,
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APPLICANT AGREES TO FURNISH THE TO ES04- -
THE TOWN OF SOUTH WINDSOR FOR ANY ES � �REQUIRED AND TO REIMBURSE
CONNECTION WITH THIS PERMIT AND THE B TANTENANCE OR REPAIR WORK IN
FOR PERMITS AS OUTLINED IN THE TOWN OF SO I �I TNb LL ABIDE BY THE RULES AND REGULATIONS
5 IT MANUAL.
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ISSUED BY D TE INSPECTED INSPECTED BY �✓
1/12/20108:25AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I00000 CONTRACTOR: CgLf )e Cons)"r.
LOCATION: 4/ CG��2
TYPE OF WORK: Yan i G jj_o& Ije .:Z ice r,�,7`
DATE INSP NEEDED: DATE INSP: 3 /o r�
INSPECTED BY: C3?Q
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT , 00000
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
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FEE $25.00 uC
Name of Firm b►e ,bl c e &Iis c 't- tac `I TAC.Phone No.
Address of Firm 7< / c ( w4 4 C zip Code 061(15�
Location of proposed work Ln °
Describe fully nature of permit requested /}jz l i! _j it 7`�L-OhwP -14))c e
Starting date ! 10 Approx.time for completion 2 w eek5
Call Before You Dig No. '10)00D3q(q
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
0 No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ tft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
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.
14 ) —
Signed: Date:it(LI C-)
Title: Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08