HomeMy WebLinkAboutStreet Cut Permits 152 Greenwood Drive (2) 1100112 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/11/11 = "
GIS ID: 38700152 FEE: 25.00
MUNIS APPLICATION# 201100890 EXPIRATION DATE: 08/10/12
APPLICANT` = LOCATION
NAME: ANDRE CHARBONNEAU&SORTS = ADDRESS: I52 GREENWOOD DRIVE
ADDRESS: 125 EDWIN ROAD (DER: BY,MAI2Y G
SOUTH WINDSOR, 4 152 GREENWOOD DR
?UTH WINDSOR,CT 06074
PHONE 860-528-7551
WORK DESCRIPTION: REPAIR;T S DEWA K SLABS
APPLICANT AGREES TO FURNISH THE T€W-K-.0F SOUTH WINDSOI2 THE AMO64� OE BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY E3�PENSES INCiJRI 31)BY THE TOWN 3aflR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICAXTIJS FAMILIAR WITH'AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED INTHE TOWN OF/SUTI3 WINDSR'S'STREET CUT PERMIT MANUAL.
Z Z///
ISSUED BY DATSIN PECTED INSPECTED BY
8/1 1/201 1 9:08AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 0/ CONTRACTOR: _ ��2�
LOCATION: reen Q0J
1YPE OF WORK: `Rupa'10-
DATE INSP NEEDED: DATE INSP: L
INSPECTED BY: 5a
WORK IN
PROGRESS:"
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: v Y DATE:
W/2007 Town of South Windsor INPSEMON REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR a Permit No.
PUBLIC.WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm6�r�0 VN6A b Phone No.
Address of Firm Zip Code_
Location of proposed work 1 C--; I 04ZVXC
Describe fully nature of permit requested t S
Starting date _ 1 ! 1 Approx.time for completion 5
Call Before You Dig No. Existing Water.Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE; THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
-PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH;TRAFFIC.CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing Indicate.North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
- Est.Curb Replacement ft
Est.Curb Unit Price$. /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Tmffio Control$
r �
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 THIS P IT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLI OWN OF SOUTH WINDSOITS STREET CUT PERMIT MANUAL.
Signed: ( Date- (�
Title: Driver's License#: tcl!l 60
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