HomeMy WebLinkAboutStreet Cut Permits 9 Cliffwood Drive (2) 1100135 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/07/11
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GIS ID:21000009 FEE: 25.00
MUNIS APPLICATION# 201101001 EXPIRATION DATE: 09/06/12
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APPLICANT" = LOCATION
NAME: YARDMEN LANDSCAPE LI C ADDRE 3 9=CLTFFWOOD DRIVE
ADDRESS: P O BOX 2030 OWN. CM114iNITY RESIDENCES INC
TORRINGTON,CT 0I 79_0_ - 7 2 WEST ST STE12
SOUTIINGTON,CT 06489
PHONE
WORK DESCRIPTION: FOR THLTiNST LLATION OFWATEIFOI /F2E SP R
APPLICANT AGREES TO FURNISH THE TOWN D_F S 0 U T ND S161WIR E AMOU*bF BAND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURREDAW-THE TOWN FAR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THEAPPLICANT-IS AI I IAR WITH AND WIC L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SCUTLI WINDS "S ST E�CUT PERMIT MANUAL.
ISSCED BY DATE INSPECTED INSPECTED BY
9/8/201110:18AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: / 0 d 13.E CONTRACTOR: Yq rd wn
LOCATION: W 0 0 ,d� t> i e,
-TYPE OF WORK: /I n i n f-erg
DATE INSP NEEDED: DATE INSP: 10 A-7 �—
INSPECTED BY:
WORK IN
PROGRESS: Zo,�i mot 6 uvt�,� L o oteK� (_d u>l -rwo ww�.L SefVlees
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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 l 00)3�
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
9,0 //D`00 J PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm_ a rAtottk Phone No. *60 14 to • SV 2!1
Address of Firm y 79 - tuna:n 6Z._'7nrr eng Zip Code 06720
Location of proposed work WFS-w.oc(> MIv
Describe fully nature of permit requested lamer he, e ti S A IA bra ale &m4r 6c 6etc
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Starting date 11 Approx.time for completion
Call Before You Dig No. Aa 11360 2lo 3/ Existing Water Supply: Q Public Water 0 Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST.OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
twg copies of separate drawing lydcate North Town of South Windsor
n � � No.cuts
• a t� (cam
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
l i st.Patch Unit Price
Est.Patch Cost$
t
sJ 66 Est.Curb Replacement ft
Est.Curb Unit Price tft
. Nt
•t`r`I Est.Curb Cost$
A� ! Est.Traffic Unit Cost
Est.Traffic Control$
Amt.of Deposit$
Total Due$
(Z, { )Cash ( )Check#
Applicant is re able for contacting Paid By
the Police Dept.and C.S.Y.D.
1 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 OUTLINED IN THE TOWN OF SOUTH WINDSOMS STREET CUT PERMIT MANUAL.
Signed: Date: Z-1 /_I(
TitleAANd,rr Driver's License m 2 Z 4 yj 9 G Sp'
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 11MES
Street Excavation Permit 08 REV 10-22-08
Sewer Connection For: Jeannette LeSure
9 Cliffwood Dr
South Windsor CT
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Designed By: Andrew Coleman 7�T
le U License#5839
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