HomeMy WebLinkAboutStreet Cut Permits 63 Natsisky Farm Road (2) __..
1100156 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 10/03/11
GIS ID: 62300063 FEE: 25.00
MUNIS APPLICATION# 201101159 EXPIRATION DATE: 10/02/12
APPLICANT" ; LOCATION
NAME: PALAZZO CONSTRUd-T'ION INC AI)DRE8-S;: Q -,AT---ISKY FARM ROAD
ADDRESS: 150 DIVIDEND RD " QWNER. " ,CALDWLL JOHN E JR&BARBARA J
ROCKY HILL, CT 06967, I�FTSISKY FARM RD
AL
SOUTH WINDSOR,CT 06074
PHONE 860-563-6468tloli
WORK DESCRIPTION: DRIVEWAY = = ==
APPLICANT AGREES TO FURNISH THE TOWN OF SOuTf-f WMSE� -TH- E_AMO�JI�I� OF BEND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY M-ENSES INCIJRRED BY" HE TOWN FO! IytAINTENANCE OR REPAIR WORK IN
IC
CONNECTION WITH THIS PERMIT AND T APPT ICAN T IS FAMILIAL WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH�1" NDSA§STREET CUT 1'ERIvI fi MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
10/3/201111:59AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
-. - .......... -..._....
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: 7.Ze 60a5Ae
LOCATION: /I I I
Cis c� ra 1'h oa_rk
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: °1,2-7/'1
INSPECTED BY:_ 6))
WORK IN
PROGRESS:
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 / 1-0/Y&
Appl.No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: tl
SOUTH WINDSOR,CT 06074
FEE $26.00
Name of Firm a V"-L L o a"rsf .. T"J C• Phone No. 960�'•��3=6�6
Address of Firm - r 'it Zip Code 06067
Location of proposed work If" h1da Si-S K-V kiln:,
Describe fully nature of permit requested
Pr
VI Pl�i 'rl'
Starting date Approx.time for completion C
Cali Before You Dig(No. ap t t Moo JA3 f{ Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST.OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND-THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
-Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North. Town_of South Windsor
4 i 17�r No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ Jsf
h r Df Est.Patch Cost
Est.Curb Replacement ft
Est.Curb Unit Price Ift
Est.Curb.Cost-
Est.Traffic Unit.Cost$ /hr
EsL Traffic Control S
Arnt.of Deposit$
Total Due S
( )Cash { )Check#
Applicant is responsible for contacting Paid By
the Police Dept.and C.S.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 A U INED IN.WE N OF SOUTH WINDSOR'S STREET CUT PE IT NUAL.
Signed: Date: 7
Title- L;Y'�� 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 JOBSITE AT ALL TIMES
Street Excavation Permlt 08 REV 10-22=08