HomeMy WebLinkAboutStreet Cut Permits 1 Austin Circle 1000116 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/08/10 ,
GIS ID: 05900001 FEE: 25.00
MUNIS APPLICATION# 201000850 EXPIRATION DATE: 07/08/11
APPLICANT" LOCATION
NAME: TELE-NETWORKS = ADORES: , "1 8 AUTIN CIRCLE
ADDRESS: 31 BAKEWELL COURT = = OR; MAIARCV OLEG&TATYANA
CRASTON,RI 02921 " AU—SIN,CIR
SOCJTI WINDSOR,CT 06074
PHONE 401-461-8420
WORK DESCRIPTION: REPLA�NG
APPLICANT AGREES TO FURNISH THE T(1WIEI OF SOUTH, II�IDS TEE AMOUNT O B6ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANI'EXPE3 SES 1NCUI I Tay—THE TDWI�FORMAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLI€ANT IS FAIvftlAR�4ifi AND"W1 L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTR WINDSR'S STREET-CUTPERMIT MANUAL.
ij
ISSUED BY DATE INSPECTED INSPECTED BY
7/8/20104:05PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 000 /(v CONTRACTOR: ���-
LOCATION , N Ci�C f
TYPE OF WORK: CA TV
DATE IN P S NEEDED:
DATE INSP: i li
INSPECTED BY: 3 D
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: (" \-" DATE: 0 `�
W12007 Town of South Windsor INPSEMON REPORT 07
o/Q 0�DSO At'I't_ILA 11UN t-Utf S 1 Rtt 1- tX4AVAT10N PERMIT 10DD//6
Appl.No. TOWN OF SOUTH WINDSOR - Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date.
SOUTH WINDSOR,CT OW74
_FEE $25.4i
Name of.Frm f£ekc--t,-ke1 li Cs k-- S Phone No. L S= Z302.
Address-of Firm 31 ��OW-QQ k k C—k C(Un S-I In R-1 Zip Code 0 Zc�Z I
Location of proposed work' T Ao;;—An 0,kvr�P
Describe fully nature of permit requested_ Re rJ la{•gi l y
Starting date 10 Approx.time for completion ' C
Call Before You Dig " "W6 1 S3 j _ Existing Water Supply. ❑Public WIter ❑Well
Existing Sewage Service. ❑Public Sewer C(Septic
PLEASE NOTE_ THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT"IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND-CURB REPLACEMENT,INCLUDING ANY INCREASES IN-PATCH AREA,CURB
LENGTK TRAFFIC CONTROL AND THE TOWN S'CONTRACT COSTS. THE PERMANENTPATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATERTHAN A YEAR.
Show sketch of proposed work or mirth This section to be ftited-out by
two copies of separate drams hxtitate North Town of South Windsor
fee AA
Jh�l1 No.cuts
0 EEsL PatchSize(s)
Est Pvt:Thickness in.
Est Patch unit Price$ fsf
Est.Patch Cost$
Est.Curb Replacement ft
Est:Curb unit trice /It
Est:Curb Cost$
Est.Traffic Unit Cost$ fir
Est.Traffic Control$
Amt.of Deposit$
Total Due S
t )Cash { }Check
Applicant is msponsUe#or contacting Paid By
the Pofrce DePL 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
CONNEC.-TI Q-N;WITH THIS-PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS THE TOWN OF SOUTH WINDSOMS STREET CUT PERMIT MANUAL
Date:
fi tle_ Drivees License#
PLEASE ALLOW AT.LEAST TWO WORKff4G DAYS AFTER APPLICATION FOR ISSUANCE OFPERMTr
WORK MAY NOT BEGIN UNTILA PERMIT HAS BEEWISSUED
PERMIT SHALL BE KEPT ON JOBSITE_ATALL TIMES
Street Excavation Permit 08 PJX 18-22=Q8'
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