HomeMy WebLinkAboutStreet Cut Permits 45 Austin Circle 1100103 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/29/11
GIS ID: 05900045 FEE: 25.00
MUNIS APPLICATION# 201100840 EXPIRATION DATE: 07/28/12
APPLICANT - - LOCATION
NAME: TELE-NETWORKS ADDRESS:" 45-'47 AVSTIN CIRCLE
ADDRESS: 31 BAKEWELL COURT OWNER BARRES!GLENN J&ALANNA J
CRASTON,RI 02921 , - "" " 45 AUSTIN CIRCLE
tip SOUTIIWINDSOR,CT 06074
PHONE 401-461-8420
WORK DESCRIPTION: REPUACIIVG GAT /
APPLICANT AGREES TO FURNISH THE TOWN�?F OUTH WINI7SOR'I`H-AMOUNT OF QND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANC'EXPENSi§INCURRED BY.T1E TOWN FOR-MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE AAPIIGANT IS FAMILIAR WITH AM WII L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WtNDSR'S STREET CUT-PP-RMIT MANUAL.
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ISSUED BY DATE INSPECTED INSPECTED BY
7/29/201110:46AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I/a /b CONTRACTOR: �li�,
LOCATION: yS' �l C f� {� r
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: 1/00112
INSPECTED BY: Q
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: tVA,_ DATE:
W12007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: 2 12-2 Lzo
SOUTH WINDSOR, CT 06074
_ FEE $25.00
Name of Firm 'I�l�'-A)e4f-Jn r`--, Phone No. �
Address of Firm 3 0:�6kprJP 11 C�- Cj-c ,k 4-(j Zip Code OQ9; 1
Location of proposed work 1qS-Q ? Au5 C,r
Describe fully nature of permit requested �14C:' exi5 r,� C Al
Starting date 20 11 Approx.time for completion 1
Call Before You Dig No. 20 11 300 3 Ke fs Existing Water Supply: ❑ Public Water ❑ Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
0 No.cuts
SheCC�r� Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price
Est.Patch Cost$
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 TH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS A LINED ININE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT AN AL.
Signed: Date: 'Z7 ze(
Title: 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
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