HomeMy WebLinkAboutStreet Cut Permit 245 Skyline Drive 1000031 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 03/08/10 *
GIS ID: 83100245 FEE: 25.00
MUNIS APPLICATION# 201000192 TION DATE: 03/08/11
APPLICAN LOCATION
NAME: TELE-NETWORKS ` S` K INE DRIVE
ADDRESS: 31 BAKEWELL COU O i L G&MARLO M
CRASTON,RI 02921 INE DRIVE
SOR,CT 06074
PHONE 401-461-8420 POWs
WORK DESCRIPTION: REPL
APPLICANT AGREES TO FURNISH THE T ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY B MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE I ' LL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN PII TOWN OF S T MANUAL.
ISSLT9D BY DATE INSPECTED INSPECTED BY
3/8/201010:45AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
1
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR:
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS: O o, ono f m 5�n 1 G�
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
i�rr�al� APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: 31 9 U
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm , e �e v N e. W U c tL- S " F�{5.23 02
Phone No.
Address of Firm w e S-�6" Zip Code Q& -2� t
Location of proposed work q� Z-S Il
Describe fully nature of permit requested Cf2aCe IV1 siek t CA-TV
Starting date Approx.time for completion
Call Before You Dig No. 2-0/d iOod�a`j Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer. ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST.OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Sizes) sf
/ Est.Pvt.Thickness in.
V-/` VIA Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /it
Est.Curb.Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of_Deposit$
Total Due$ s
( )Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police De t.and C.B.Y.D.
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 A U ED IN.THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
gned
Date: 3—02 16 -
i 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
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