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Home My WebLink AboutStreet Cut Permits 9999 Carey Lane 1000158 PERMIT NUMBER /-'-/TOWN OF SOUTH WINDS OR DATE: 08/11/10 � / �- STREET CUT PERMIT GIS ID: 16809999 -_ MUMS APPLICATION# 201001036 Aw Ar FEE:low E &RATION DATE: 25.00 APPLICANT '% 08/11/11 NAME: COOKER CONSTRUq-- L ADDRESS: 8 EGYPT ROAD = �2 %i C LOCATION SOMERS, CT 06071 = OW W. SANE 0 O SOUTH WINDSOR PHONE , ' = 34U sUL IVAN AVE WIISSR, CT 060742734 WORK DESCRIPTION: LOCAL"ERIILI � APPLICANT AGREES TO FURNISH THE TC;.. � 'IT$zALONG AREY LANE THE TOWN OF SOUTH WINDSOR FOR ANY p-�-E- UE - CONNECTION WITH THIS PERMIT AND THE A'PI I ANT D ��D T--QF AND REQUIRED AND TO REIMBURSE FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WII©SR f HE SOW FOWMAINTENANCE OR REPAIR WORK IN AAR KITH ANDfLL ABIDE BY THE RULES AND REGULATIONS r BUT PMIT MANUAL. ISSUED BY f DATE INSPECTED =� v 8/11/20102:26PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** INSPECTED BY ------------ _------___- TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: 100al CONTRACTOR: LOCATION:_ C k e u 1_&aL-� TYPE OF WORK: /i/---e 4*i-:� oa DATE INSP NEEDED: DATE INSP: 3 INSPECTED BY: e b WORK IN PROGRESS: �n�-e.._ SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION APPLICATION FOR STREET EXCAVATION PERMIT /Tr/S 6 Appl. No. TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT 1540 SULLIVAN AVENUE Date: 2-6/6 SOUTH WINDSOR, CT 06074 FEE $25.00 �I /1 pQ�� 1 Name of Firm l c�i��/ � -n L Le Phone No. 6006 14 co�Address of Firm er u, RA . � ors 0 • Zip Code S Y�tO Location of proposed work i C y7 6,46a 3 Describe fully nature of permit requested kXoAy4 1°• ss 5 is S Starting date a56 1 Approx.time for completion Call Before You Dig No. a?]njy 3366 Existing Water Supply: ❑ Public Water ❑Well Existing Sewage Service: ❑ Public Sewer ❑ Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch of proposed work or furnish This section to be filled out by two copies of separate drawing Indicate North Town of South Windsor No.cuts 0 Est. Patch Size(s) sf Est. Pvt.Thickness in. Est. Patch Unit Price$ /sf Est. Patch Cost$ Est. Curb Replacement ft Est. Curb Unit Price$ /ft Est.Curb Cost$ Est.Traffic Unit Cost$ /hr Est.Traffic Control$ 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 S OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. --_----Signed Date -- -- - - Title: i:�(L I,AA evtkb Q f 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