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HomeMy WebLinkAboutStreet Cut Permits 9999 Gray Road (3) 1100065 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 06/24/11 -_ = GIS ID: 38109999 = FEE: 00 MUNIS APPLICATION# 201100650 = —' EXPIRATION DATE: 06/23/12 APPLICANT LOCATION NAME: J&H SLATER CONST CO:- = - - ADDRESS: GRAY ROAD ADDRESS: 75 COMMERCE WAY ©DER TOWN"O SOUTH WINDSOR SOUTH WINDSOR,GT 06074 }540 SULLIVAN AVE '. VINDSDR,CT 060742734 PHONE 860-528-5252 = WORK DESCRIPTION: REPAIR ONCII ETE DRAINAGE PIPE TOWN PROJECP NG PEE ; APPLICANT AGREES TO FURNISH THE TfaWN DF SOUTH WINUSOR Tt 'AMQUNT C)I~BOND REQUIRED AND TO REIMBURSE ,- THE TOWN OF SOUTH WINDSOR FOR ANY EXPENSES Ii�fCURI3ED BY THE T4WNFOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMILIAR WITI�AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF sQUTff WINDSR'S STREET CUT-PERMIT MANUAL. ISSUED BY DATE INSPECTED INSPECT BY 6/24/201111:19AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: I Oba(S CONTRACTOR: �" s )f`�r LOCATION:(�Q TYPE OF WORK: A6600 `Pt awn DATE INSP NEEDED: DATE INSP: 7 1,2 INSPECTED BY: t3-D WORK IN PROGRESS: _ H Sib. r. a SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: U W/2007 Town of South Windsor INPSECTION REPORT 07 APPLICATION FOR STREET EXCAVATION PERMIT 1/,0006,S— Appl. No. TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT 1540 SULLIVAN AVENUE Date: /1 SOUTH WINDSOR, CT 6074 FEE , p A&*r Name of Firmly 2 C. Phone No. Address of FirmIZA 07Zip Code Q Location of proposed work Describe fully nature of permit requested Ii4!/Z �B C�� /2/�!✓ �� !�/ � Starting date 2' 1/ Approx.time for completion �9 Cali Before You Dig No. 1/2 0 Existing Water Supply: (9Public Water ❑Weil Existing Sewage Service: 10 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 Thts se4tion to be filled out by two copies of separate drawing Indicate.North Town of South Windsor No.cuts Est.Patch Sizes) Est.Pvt.Thickness AA in. Est.Patch Unit Price$__k1A /sf 2 Est.Patch Cost Est.Curb Replacement �ft Est.Curb Unit Price$_ N11 /ft Est.Curb Cost.$ AIX Est.Traffic Unit Cost$ r Est.Traffic Control s. NA 124 Arnt.of Deposit$ NR Total Due$ ( )Cash ( )Check#- Applicant is responsible for contacting Paid By lux 1. the Police Dept,and C.S.Y.D. I AGREE URNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN O TH.WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNEC WITH THIS PERMIT AND THAT 1 AM FAMILIAR-WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMIUAS TLINED!N.THE OW F SOUTH WINDSOR'S STREET CUT/PERMIT MANUAL. Signed Date:_ Title: 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 t:xcavadon.Permit 08 REV 10-22-08