HomeMy WebLinkAboutStreet Cut Permits 122 Greenwood Drive (2) 1100125 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/22/11
GIS ID:38700122 FEE: 25.00
MUNIS APPLICATION# 201100945 DXPIRATION DATE: 08/21/12
APPLICANT LOCATION
NAME: CHARBONNEAU CON BETE ENT ItPRI_ES ADDRESS: 122 GREENWOOD DRIVE
ADDRESS: 125 EDWIN ROAD OWiT I ELL1- TTDONALD E&KATHRYN E
SOUTH WINDSOR,CT 6074; „ 122-GREENWOOD DRIVE
SOUTH WINDSOR,CT 06074
PHONE
WORK DESCRIPTION: SIDEW1 REk?LACEIvIENT ,
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR T IE AMOUNT OE-BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANi E ENSES INCURRED BY THE TQWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT-IS FAMILIAR WITH ANI3 WILT,ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF 3QUTH WINDSR'-S STREET CUT PERIEIIT MANUAL.
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ISSUED BY DATE INS E ED INSPECTED BY
8/22/20113:33PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I100 i 1, CONTRACTOR: C1 28i7nnEAU
LOCATION: I &ree n Woc�
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: '-)
INSPECTED BY:
WORK IN
PROGRESS: 4 S ;,� ,o-\o— .t pci, eQz (2e 2cccx Sy--"s L► q
AS-BUILT:
INPUT: DATE: y
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W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
,a S®�
•Name of Firm � Phone NoO U__)� 9 1�
Address of Firm �� W hV_ So, . Zi Code 0 Uo}l
Location of proposed work I a 19L C-P.h W a �
Describe fully nature of permit requested 2i �i �
Starting date I l Approx.time for completion '
Call Before You Dig-No. Existing Water Supply: []'Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of.South Windsor
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ fft
\ Est.Curb Cost S,
Est.Traffic Unit.Cost$ /hr
Est.Traffic Control s
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. AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS 0 IN T OWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date• DR t ^(
Title: h�� " ' '� 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 JOSSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08