HomeMy WebLinkAboutStreet Cut Permits 5 Saddleback Drive 1000186 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/10/10
GIS ID: 78900005 FEE: 25.00
MUNIS APPLICATION# 201001205 E 'IRATION DATE: 09/10/11
APPLICANT-,? k LOCATION
NAME: COOKER CONSTRUCTION. DRESg 5 SADDLEBACK DRIVE
ADDRESS: 8 EGYPT ROAD OWNATII WENDY N&RICHARD A
SOMERS,CT 06071 ;` 4 DDLEBACK DRIVE
SOUTH WINDSOR,CT 06074
PHONE
WORK DESCRIPTION: LOCATEP�?SE SPLICE LOCATI(}NS=F(R AT&T
APPLICANT AGREES TO FURNISH THE TbWI OF SOUTHDSOR TOTE AMOUNT OF B(SND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN)hj&EN 3hS INCURR 3=BY,THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE AVPLICANT'IS FAME IAR V4 FH ANI WII L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWNOF/SOUTH WINDSRfS T$EET CUT PERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
9/10/20103:08PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: l I86 CONTRACTOR: C 6n k2i_
LOCATION:,-5- SQ dJ/
e� /G !/ Uke
TYPE OF WORK: Vom_,tea- S ,a P S412 644g)OL2s 4�L
DATE INSP NEEDED: DATE INSP: 1 ,1611 z-
INSPECTED BY: ED
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: CUN�_
DATE:
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: d
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm aw-s'I1-yyc�'f&c LLB. Phone N0(5 b/.3 a g-5�Z'�rU
Address of Firm ' Zip Code DfQCY
Location of proposed work 16cAL 011
Describe fully nature of permit requested Lrc
Starting date v Approx.time for completion R
Call Before You Dig No. O-DIt) 1??�f Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
0
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price
Est.Patch Cost$
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
CONNEC ION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS UTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL,
Signed Date:
Title: 1►' r c/���C I Ly Driver's License#:C-'_ /64&-9/61 Y 4?
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
Molloy, Catherine
From: CallCenter@CBYD2.com
Posted At: Wednesday, September 08, 2010 4:03 PM
Conversation: Locate Request-20103701774
Posted To: CBYD
Subject: Locate Request-20103701774
(CALL BEFORE YOU DIG - CT) 09/08/2010 16:02:46
-5G -C1 -CW -GV
-J1 -OT 10-SW SWINDS -T5
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***** ROUTINE *****
TIME. .16:02 DATE. .09/08/2010
REQUEST NO. . .20103701774
LATITUDE. .41.8516165 LONGITUDE. .-72.5642995
TOWN. . . . . .SOUTH WINDSOR
ADDRESS. . .5 - 72
STREET. . . .SADDLE BACK DR
NEAREST
CROSS STREET. .MORGAN FARMS DR
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TYPE OF WORK. . . . .EXC TO LOC AT&T SPLICE PITS
AREA IS MARKED. . .YES
REMARKS:
WORKING IN FRONT OF PROPS:5-11 & 64-72
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START DATE. . . . . .09/11/2010 START TIME. .07:00
CALLER. . . . . . . . . .DEBBIE BARNES
CALL BACK. . . . . . .8-5PM
PHONE #. . . . . . . . .860-763-2783
FAX #. . . . . . . . . . .860-763-2783
ALT. PHONE #. . . .
EMAIL ADDRESS. . .
CONTRACTOR. . . . . .COOKER CONSTRUCTION
ADDRESS. . . . . . . . .344 BILLINGS RD
CITY. . . . . . . . . . . .SOMERS
STATE. . . . . . . . . . .CT
ZIP. . . . . . . . . . . . .06071
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EXCAVATOR DOING WORK. .SAME
ISSUED TO: DATE: TIME: BY:
DATE/TIME ARRIVED: TIME LEFT: COMPLETED BY:
CALL BACK: 1) DATE: TIME: BY: 2) DATE: TIME: BY:
PERSON CONTACTED: PERSON CONTACTED:
1