HomeMy WebLinkAboutStreet Cut Permits 580 Clark Street (2) 1100117 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/12/11
GIS ID:20400580 FEE: 25.00
MUNIS APPLICATION# 201100903 EXPIRATION DATE: 08/11/12
APPLICANT = LOCATION
NAME: J&H SLATER CONST CQ = ADDDRESS: 51WCLACK STREET
ADDRESS: 75 COMMERCE WAY OWNER: SIUIITH SHIRLEY W
SOUTH WINDSOR,CHI Q7 - 80 CLARK STREET
- -- SOUTH WINDSOR,CT 06074
PHONE 860-528-5252
WORK DESCRIPTION: INSTALL E�VATR SERVICE
APPLICANT AGREES TO FURNISH THE TOWN OF-SOUTH WINDSOR THE'AMOUI*IT O BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANYEXPENSES IN66-REI?BY--THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANTUS FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSR'S EEC CUT PER-MIT MANUAL.
ISSUED BY DA E MPECTED INSPECTE BY
8/12/20119:17AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: -_-sr* H S
LOCATION:
TYPE OF WORK: ' ' sn,s )� Aef
f'V
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: R�
WORK IN
PROGRESS: S 1c,
f
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C& DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT 1 />
Appl.No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: P / 1
SOUTH WINDSOR,CT 06074
{ FEE $2500
Name of Firm Phone No. ' � Z
Address of Firm CO&tL4 Zip Code
Location of proposed work 0
Describe fully nature of permit requested t/1 !615-
Starting date l /I Approx.time for completion
Cali Before You Dig-No. 6 2T�`r3 Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST.OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PAT614 AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWNS CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This,section to be filled out by
two copies of separate drawing Indicate.North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
Est.Pvt..ThIdmess in.
Est.Patch Unit Pdoe.$ /sf
Est.Patch Cost$
I Est.Curb Replacement ft
Est.Curb Unit Price$ fft
►�� i✓xlsrlfS4
Z Est.Curb Cost-
Est.Traffic Unit.Cost$ /hr
L Traffic Control$
Amt.of Deposit$
Total Due S
( )Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police-Dqpl.and C.S.Y.D.
I_AGRE TO F RNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
TOWN F TH.WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNE TI. WITH THIS PER THAT I AM FAMILIAR WITH AND WILL ASIDE BY THE RULES AND REGULATIONS FOR
PERMIT A OUTLINED IN THE IF � N OF`SOUTH WINDSOITS STREET CUT PERMIT MANUAL.
Signed- Date: <
Title: Driver's License M
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 EkcarAon Permit N REV 10-22-M