HomeMy WebLinkAboutStreet Cut Permits 300 Pleasant Valley R (2) 1100146 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/22/11
GIS ID:72900300 - FEE: 25.00
MUNIS APPLICATION# 201101102 - EXPIRATION DATE: 09/21/12
APPLICANT - ;- ", " LOCATION
NAME: TELE-NETWORKS ADDRESS: 300 PLEASANT VALLEY ROAD
ADDRESS: 31 BAKEWELL COURT FISIIMAN HERBERT B&RUTH R TRUSTEES
CRASTON,RI 02921 11 NIGH POINT LA
WESTIARTFORD,CT 06107
PHONE 401-461-8420
WORK DESCRIPTION: INSTALL'IREP d =
APPLICANT AGREES TO FURNISH THE WI OIL-SOUTH WII*dDSCR T AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPEINSES INCU REI 8Y THE TOWN -ORMAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TH�ANTIS FAN IAR WI�'H ANC WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OFsOUTH WINDR'S STREET CUT,PEICIIT MANUAL.
ISSUED BY DA E TED INSPECTED BY
9/22/20112:39PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /b0/ CONTRACTOR: l ear/Lls'
LOCATION: 300
j/LC
.TYPE OF WORK:
__A0&,v
DATE INSP NEEDED: DATE INSP: i G el
INSPECTED BY: ab
WORK IN
PROGRESS:_
SEPTIC TANK PUMPED, SMASHED, FILLED WTfNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT. DATE: r
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT /� f
1540 SULLIVAN AVENUE Date:`' "
SOUTH WINDSOR, CT 06074
FEE $25.00 ,, _
Name of Firm (2 vo- 0( --�w ocv-- S Phone No. 8t�o
Address of Firm 1 OL C d y V-\C (ZZ Zip Code 0 Z(�k(D 3
Location of proposed work 36o vg ce ai s6 Jq
Describe fully nature of permit requested 1 C 67
Starting date (-0 - 15P.6 t r Approx. time for completion
Call Before You Dig No. l 316 q Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate(drawing ,��/ p Indicate North Town of South Windsor
a ` "� C' "�-"" No.cuts
0
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price
Est. Patch Cost$
Est. Curb Replacement ft
Est. Curb Unit Price$ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.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 LINE T E TOWN OF SOUTH WINDSOR'S STREET CUT PERMITMANUAL.
Si ed: Date:
tle: 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
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