HomeMy WebLinkAboutStreet Cut Permits 25 Natsisky Farm Road (2) 1100154 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 10/03/11
GIS ID: 62300025 = FEE: 25.00
MUNIS APPLICATION# 201101157 = EXPIRATION DATE: 10/02/12
APPLICANT a ;- LOCATION
NAME: PALAZZO CONSTRUCTI_JN `NC.. ARDRES&. 25 NATSISKY FARM ROAD
ADDRESS: 150 DIVIDEND RD DESIIvIOE DOREEN E
ROCKY HILL, CT 06067-, = 2 NAT%SKY FARM RO
SIOU W INDSOR,CT 06074
PHONE 860-563-6468 = -
WORK DESCRIPTION: DRIVEWAY
APPLICANT AGREES TO FURNISH THE T`flWN,OP SOUTH WiI7DSO THE AMOUNT OR BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY- XPENSES INCURUI)BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THi r-FPI ICAN IS FANI��,IAR WITH A_1 WALL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSR'SSTREET CLTTPEINIIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
10/3/201112:03PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I001SCONTRACTOR:
LOCATION:_ - 2 S— k)ct 4, i s)�y
'TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: /O
INSPECTED BY:_ RN
WORK IN
PROGRESS• Q
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
W12007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT //00lS
Appl.No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1640 SULLIVAN AVENUE Date: /!
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm P414-z-zo i Phone No. 9�d —59 3— '"A6 8
Address of Firm c-t -11 - C. . Zip Code j30 67
Location of proposed work
Describe fully nature of permit requested
Starting date 3 ( Approx.time for completion
Call Before You Dig-N . /3-Z6 a3 A)_ Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST.OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND-THE TOWN'S CONTRACT COSTS.THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness In.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Priv Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due S
( )Cash O Check#
Applicant is responsible for contacting Paid By
the Police-Dept.and CA.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 PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS TLINED IN T WN OFSOUTH WINDSOR'S STREET CUT PE7 IT NUAL.
Signed: �`r'GG Date•
Title.-_ Driver's License#; �� f
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