HomeMy WebLinkAboutStreet Cut Permits 239 Oak Street (2) 1100129 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/29/11
GIS ID: 65400239 FEE: 25.00
MUNIS APPLICATION# 201'100968 EXPIRATION DATE: 08/28/12
APPLICANT LOCATION
NAME: QUALITY PAVING CJ ADDRESS: 239-OAK STREET
ADDRESS: 194 S.MAIN STREET C��TIxFER: FITT H ?WARD E&SUZANNE S
EAST WINDSOR,CT0688 239 "OAK'STREET
SOUTH WINDSOR,CT 06074
PHONE 860-523-4182
WORK DESCRIPTION: DRIVEVY
APPLICANT AGREES TO FURNISH THE TQWIYI OF SOUTH-WINbSQR TUE AMOUNT OF-0 ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY-=.EkPI NSES INCURRED3 BY THETOWN FOR-MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS I:AMII IAR WITH AND WIFL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF" UTI3 WINDSR S_7 T- ET CUT PERMIT MANUAL.
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ISSUED BY DATE INSPECTED INSPECTED BY
8/29/201111:25AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: pqu-ii)q
LOCATION:_
.TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:_ ca s o
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: - DATE:
W/2007 Town of South wndsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT I ��a►
Appl. No. TOWN OF SOUTH WINDSOR Permit o.
PUBLIC WORKS DEPARTMENT
1640 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of firm • �- Phone No. nc S Z 3 y I
Address of Firm1ZE' oICZ4 ,�, t tJ �� Zip Code
Location of proposed work
2 3 .�
Describe fully nature of permit requested
St rung date 4/� Approx.time for comple
Call Before You Dig No. 3SD Z k'7� Existing Water.Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF.THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
L.ENGTH;TRAFFIC.CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
i r Est.Pvt.Thickness in.
3d 7 Est.Patch Unit Price$ _ /sf
.---`- ......... -- Est.Patch Cost$
�G Est.Curb Replacement ft
;.50 Est.Curb Unit Price_$_ /ft
3 Est.Curb Cost-$
/Z / Est,Traffic Unit Cost$ /hr
�) Est.Traffic Control$
AmL of Deposit$
Total Due$
O Cash O Check#
iz
Applicant is responsible for tacting Paid By
.
the Police Dept.and C.B
rtj
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 1 AM FAMILIARWITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Dater
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 c r. Dona(dA.D.Avanzo
1s2 Carriage Dr.
Street Excavation Permit 08 REV 10-22-08 -%lanchester, CT 06040