HomeMy WebLinkAboutStreet Cut Permits 459 Foster Street (2) 1100126 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/22/11 --
GIS ID:33600459 FEE: 25.00
MUNIS APPLICATION# 201100946 EXPIRATION DATE: 08/21/12
APPLICANT ;` = LOCATION
NAME: AIROLDI'S INC. _ = AJDDRES& 459 FOS'-ER STREET
ADDRESS: P O BOX 71 OWNER: HARTI ORI B &TERRY
SOUTH WINDSOR,GT 40074 459 FQSTER STREET
OUT WINDSOR,CT 06074
PHONE
WORK DESCRIPTION: DRIVEWAY
APPLICANT AGREES TO FURNISH THE TOW>IOF S0UTH WIN DSOR THEAMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INGUI TIED BY THI;TOWN FpR ItfAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT LS IFAMIAR WfTH ANWIL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SQUTH WINDSR'SV ET"CUT PERMIT MANUAL.
ISSUED BY DATE sftCTED INSPECTED BY
8/22/20112:55PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 0 0Id A v 0 o4 I �CONTRACTOR:
LOCATION:
rME OF WORK: \ wa
'DATE INSP NEEDED: DATE INSP: �'9 Id,
INSPECTED BY:
WORK IN
PROGRESS:_ i1®
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑ YES ❑ NO
'AS-BUILT.
INPUT: DATE:_ I
W12007 Town of South Windsor INPSECITON REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm "���1 �-�� Phone No
. � 6
Address of C—A Zip Code
Location of proposed work `-l-S`k
Describe fully nature of permit requested Z,\
Starting date `a3 \� Approx. time for completion '-'4-
Call Before You Dig No. `ate\\3�}0�6�.�1 Existing Water Supply: ❑ Public Water ❑ Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
i two copies of separate drawing Indicate North Town of South Windsor
I
No. cuts
I
Est. Patch Size(s) sf
Est. Pvt. Thickness in.
I
\ Est. Patch Unit Price$ isf
Est. Patch Cost$
Est. Curb Replacement It
I
Est. Curb Unit Price$ /ft
i
Est. Curb Cost$
I
Est, Traffic Unit Cost$ /hr
I
Est.Traffic Control $
I
Amt. of Deposit$
Total Due$
i
( ) 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 PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
P E R M I UTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL,
Signed: Date: ��`l\\0
Title: 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 Permit 08 REV 10-22-08
\ V
\a
,
fi
\fib
I �
E�\b
v
\a
fi
\fib