HomeMy WebLinkAboutStreet Cut Permits 41 Jonathan Lane (2) PERMIT NUMBER II4
PER TOWN OF SOUTH WINDSOR, CT
P
STREET CUT PERMIT
DATE: 07/08/10 ,-
GIS ID:47800041 FEE:
MUNIS APPLICATION# 201000848 = 25.00
EAPRATION DATE: 07/08/11
APPLICAN417 - LOCATION
NAME: TELE-NETWORKS 1tE-s 41 -47 JONATHAN LANE
ADDRESS: 31 BAKEWELL COURT O�YIIEIt. WEAER DANA J&TIZZIANA F
CRASTON,RI 02921 41 ONATHAN LA
IR
S9UTH1NDSOR,CT 06074
PHONE 401-461-8420 = =
WORK DESCRIPTION: REPLACE CATV
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH V NDSOWTH-E% T OF"BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY XPEIS INCURREI3�Y THE I OWE F(5R MAINTENANCE OR REPAIR WORK IN
1'PLICANT
CONNECTION WITH THIS PERMIT AND THE 4 S FAMIIIIARWITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH*..lNDSR-S.STREET CUT PERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY '
7/8/20103:16PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 001 CONTRACTOR: , ' p et&� 5
LOCATION: -i `tf�t� l la V_z
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: .6
WORK IN
PROGRESS: /►or,� �'i�, ,� � �1 ,�� K,I
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
W12007 Town of South Windsor INPSECTION REPORT 07
ANI'Ut;A t IUN ruts 5 t;titt=t- hxc wvA-nON PERA IT /o00
Appl.No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
Is"SULLIVAN AVENUE Bate:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of.Firm Phone No.�'���
Address of Firm 5 !i C f 0,V" 9 i Ci'1 ` Tip Code(3 Z`A 2
Location of proposed work cs
Describe fully nature of permit requested Q
Starting date 16 Approx.time€ru completion
Cali Before You Dig o_ 2C l U a 1� � Existing Water Supply: ❑Public W er Welt
Existing Sewage Service: Q Public Sewer Q Septic
PLEASE NOTE: THE DEPOSIT-FOR THE PERMANENT PAVEMENT PATCH:AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE.FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND-CURB REPLACEMENT,INCLUDING ANY INCREASES N PATCH AREA,_CURB
LENGTH,TRAFFIC-CONTROL AND,THE TOWNS CONTRACT COSTS. THE.PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This sectiar:ti)be wed.out by
tuna copies of separate drawing Indicate North Town of South Windsor
see No-cuts
Est.Patch Size{s sf
Est.PvL Thickness in.
Est Patch Unit Price$ - lsf
Est Patch Cost$
Est Curb Replacement ft
Est.Curb Unit Price$ /it
Est Curb Cost$
Est Traffic Unit Cost$ thr
Est Traffic Control$
Amt of Deposer$
Total Due$
( 3 Gash I )Check#
Applicant is responsible for contacting Paid By
the Police Dept.and G.B.Y.D.
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND.REQUIRED AND TO REIMBURSE THE
TOWN OF SOUTHVINDSOR-FOR ANY.EXPENSES INCURRED BY THE T`OW FOR-MAINTENANCE OR WORK IN
CONNECT -N WITH THIS PERMIT AND THAT i ALI FAMILIAR WITH AND WILL ABIDE BY THE RUMS AND REGULATIONS FOR
PERMITS ITS OUTU THE TOWN OF SOUTH WINDSOR`S STREET CUT PERMIT MANUAL
�gned:
Date: Q-� c��—►-�—
T lit e: Driver`s License#_
PLEASSEALALLLIDW AT LEAST TWO iAl`ORIGNG HAYS AFrM APPLIGATION FOR'ISSUANCE OF PERK
WORK MAY NOT BEGIN UNTIL A PERNI'i'HAS BEEN-ISSUED
PERMIT SHALL BE KEPT ON JOBSITEATALL TDIIES
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