HomeMy WebLinkAboutStreet Cut Permits 295 Rye Street (2) 1100079 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 07/06/11 - -
GIS ID:78600295 "" FEE: .00
MUNIS APPLICATION# 201100707 EXPIRATION DATE:
APPLICANT " " =LOCATION
NAME: YANKEE GAS "" A71IES 295 R STREET
ADDRESS: 112 PROSPECT HILL RD�-=_ - OWAI AL3JFINC.
EAST WINDSOR, CT Q608'$ , , - = 2 ZYE STREET
SOUTH-WINDSOR,CT 06074
PHONE 860-292-2242
WORK DESCRIPTION: REPLACE TEST BOX IN STRHT�N FRONT(Q AI IDS
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR--! HE AMOUNT OII,BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY kPtNSES INCURRED$Y THE TOWN FQ-j 1V AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMILIAR WITH AND WIL1`ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTHWINDSR'S TREE f CUT PE RMT MANUAL.
ISSUED BY jbATENSPECTED INSPECTED BY
7/6/20111:13PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 6ev - CONTRACTOR: a. B 6�4,S
LOCATION:___d 9 S- psi p S ja �f
TYPE OF WORK:— ko4D SQL qe b&v &17
DATE INSP NEEDED: DATE INSP: 1
INSPECTED BY:
WORK IN
PROGRESS: 4 1 � r X ./ z '" cut /rr 40 &)a c c S7k6l,
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT:
DATE:.
W/2007 Town of South Windsor INPSECIION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT II L
Appl. No. -TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
'1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074 .
FEE $25.00
Name of Frm lcty- ��a (,'- Phone No. of o.�i �D- }d
Address of Firm 1�r�U e Zip Coded p
Location of proposed work
Describ�fully nature of permit requested o 6-Fee oTj o
Starting date 3 0 ► Approx.time for completion o41 n%1
Call Before You Dig No.bl0 4 X0 851) Existing Water.Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE; THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST.OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH;TRAFFIC.CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing
Indicate:North Town of South Windsor
No.cuts
Est.Patch Sizes) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price_$_ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control S
AmL of Deposit$
Total Due$.
( )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
PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT/MANUAL.
Signed: �✓'' �—'� Date: l_3a b a l l
Title: Driver's License M 6 3Z,9 f Q�a y
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UN71L A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08
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1:800 1-41.7- 83.31
The material contalned on thls map Title:
shall be considered proprietary to I
Yankee Gas and user (which is
defined as any person oren"',
y'
who has receroed the ge throw h
sale,purchase, exchange, gift, or
otherwise)shall keep it in confidence
and shall not furnish or disclose it
to any third party without the prior Information shown is not quaronteed and Yankee Gas assumes no responsibility. The Norlhec�si Ul�ifll8YSICtri
written permission of Yankee Gas. Contractors are urged to call Yankee Gas for further information of 1-800-989-090p tl e: — Ur1— 107 Selden St.,Berlin C7 06037
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