HomeMy WebLinkAboutStreet Cut Permits 96 Rugby Lane 1000136 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER - STREET CUT PERMIT
DATE: 07/28/10
GIS ID: 78000096 = FEE: 25.00
MUNIS APPLICATION# 201000953 41 I RATION DATE: 07/28/11
APPLICANT - LOCATION
NAME: TELE-NETWORKS = % !AlI3RESS 9�RUGBY LANE
ADDRESS: 31 BAKEWELL COUJ-- n CA R, C MARION A
iz
CRASTON,RI 02921iIGB 'LA
SQUrINDSOR,CT 06074
PHONE 401-461-8420
WORK DESCRIPTION: REPLAGilk
G EI IIN CME-
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APPLICANT AGREES TO FURNISH THE T&Nbf S UTIf-i VV N-- k-' Vf,1MC}UNTT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY�W UM-0 1-NTH I OWI FO MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APL IOANT:Ii<AMLIAR VITHND,WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S IT MANUAL.
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ISSUED BY DATE NSPECTED INSPECTED BY
7/28/20102:45PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
_,,,
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: l Oaf 13 6 CONTRACTOR:
LOCATION
TYPE OF WORK: �aG/
DATE INSP NEEDED:__ DATE INSP: 1 1 3�iz
INSPECTED BY:
WORK IN
PROGRESS:_
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
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INPUT: l� �.�
DATE '
W12007 Town of South wndsor INPSECTION REPORT 07
ANf'L.It:A t IUN f-UK S t Ktt I LXUAVATION PERMIT f 00`9 136
)pl.No. TOWN OF SOUTH WINDSOR Permit No.
.r
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
— �- . is
Name of Fart �'�'` E ; Gt S Phone No-t v� `& e 2.3 02.
Address-of Firm 5 C(un r�i Gi", ZT Zip Code 0
Location of proposed work q/
Describe fully nature of permit re- uested_ 6c-\n6if
e 7" �n(� ox_lime for
Starting date e o completion
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Cali Before You Dig Na. 26 Z I OG 7,q,?- Existing Water Supply: ❑Pubic Water El well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE-DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWWS CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
See_ No.cuts
0 Est.Patch Size(s) sf
Est.Pvt<Thickness in.
Est.Patch Unit Price$ 1st
Est.Patch Cost$
Est.Curb Replacement it
EsL Curb Unit Price$ /ft
Est.Curb Cost$
Est Traffic Unit Cost$ 1hr
Est.Traffic Control S
Arm_of Depos+r $
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
CONNECj WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PER OUTLID y THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL
t ioned- car _; 1 Date:
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T'tl�e: 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 1G-22-08
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