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HomeMy WebLinkAboutStreet Cut Permits 376 Pleasant Valley R (2) 1100182 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 12/19/11 - GIS ID: 72900376 FEE: 00 MUNIS APPLICATION# 201101518 ," EXPIRATION DATE: APPLICANT - = ,= LOCATION NAME: YANKEE GAS ADDRESS: 376 PLEASANT VALLEY ROAD ADDRESS: 112 PROSPECT HILL RIB -` 6WIIR: BLAIQ;LOUIS J&KATHERINE N EAST WINDSOR,CT 06Q$8 375 PLEASANT VALLEY OUTII*INDSOR,CT 06074 PHONE 860-292-2242 WORK DESCRIPTION: INSTAI GAS, RVICE APPLICANT AGREES TO FURNISH THE TOWN-OF"SOUTH W-IND-9 R TIIE AMOUNT OF 3 D REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANiij&ENSES TNCURREI).BY THE T-OWN FOR M--AINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THEAPP k ANTP-I-FA LIAR WITH Ah- WI L ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SQiITI WINDS�2'S TREE I CUT PERMIT MANUAL. C, vlry Z- rt- ISSUED BY DATE INSPECTED INSPECTED BY 12/19/20118:53AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: Ll ©(?I ,:�- CONTRACTOR: ~�� �► ) p LOCATION: .S 10 pa-s TYPE OF WORK:_ s s'Aa I I y)e ql Q S '5�OA y i DATE INSP NEEDED: DATE INSP: Z 9 �z INSPECTED BY: 66 WORK IN PROGRESS:_ SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO 'AS-BUILT.- INPUT, DATE: �-- W/2007 Town of South Windsor INPSECTION REPORT 07 12/03/2011 SAT 10: 59 FAX 860 292 2202 0002/002 APPLICATION FOR STREET EXCAVATION PERMIT �/� 4� Appl. No. TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT 1540 SULLIVAN AVENUE Date: SOUTH WINDSOR,CT 06074 FEE $25.00 Name of Firm N n�P-Q 670-S Phone No. Address of Firm - tYIC '-Qt" Zip Code_LAaDY Location of proposed work 3-7(.,0 nl l Describe fully nature of permit requested l V is U_ Starting dateI Approx.time for completion ! C A Call Before You Dig No. c9-�LI _ Ot 0 Existing Water Supply: ❑ Public Water ❑Well Existing Sewage Service: ❑ Public Sewer ❑Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENOTfii-TRAFFIC CONT'RGL-ACID-T44t.-TOWN?SCGNTR-AG1'-GGSFS: THE,PERMANENT PATCH IS-TYPICAL Y COMPLETED WFMIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch of proposed work or furnish This section to be_fidled out by two copies of separate drawing Indicate North Town lof South ftdsor 3,(4p No.cuts ( iAi Mat Est.Patch Size(s) sf 5�5n , CO. l Est.Pvt.Thickness in. Est.Patch Unit Price Est.Patch Cost$ IY� Est.Curb Replacement ft i Est.Curb Unit Price 3"l Est.Curb Cost$ Est.Traffic Unit Cost$ /hr ✓&/,t Est.Traffic Control$- ry Amt.of Deposit$ Total Due$ ( )Cash ( )Check# Applicant is responsible for contacting. Paid By the Police Dept.and C.B.Y.D. 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 WUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: Date: Title A10) Driver's License M 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 JOSSITE AT ALL TIMES Street Excavation Permit 08 REV 10-22-08