HomeMy WebLinkAboutStreet Cut Permits 33 Sele Drive 1100185 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 12/23/11
GIS ID: 81800033 FEE: 00
MUNIS APPLICATION# 201101536 EXPIRATION DATE:
APPLICANT LOCATION
NAME: YANKEE GAS EL ADDRESS: 33 SE=DRIVE
ADDRESS: 112 PROSPECT HILL RD ER: APTIANSE VINCENT&ANTONINA C
EAST WINDSOR,CT 06Qs-8 33 SELE DR
-- = SOTJTI VINDSOR,CT 06074
PHONE 860-292-2242
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WORK DESCRIPTION: EXCAVAYE TO NSTAlT1E GAS SERVIG
APPLICANT AGREES TO FURNISH THE T QWI!OF SOUTH NDSOR'THE AMOUNT OF-B�3ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY E�PENSES-INCIIR ED BY,TH1a TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE A.PKL I ANTIS FAMII IAR WITfI AND WT L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOLfT1I WINDSR S TR7 ET CUT PERMIT MANUAL.
ISSUED BY D E IN ftCTED INSPECTED BY
12/23/201110:59AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1L001Y CONTRACTOR:
LOCATION:_- , V-42-
TYPE OF WORK:__ i I� ,� I °' t��✓1
DATE INSP NEEDED: DATE INSP: I 12 1/
INSPECTED BY:
WORK IN
PROGRESS: f, 0 virr-
CA
sY f
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
'AS-BUILT:
INPUT: DATE: Y-
W12007 Town of South Windsor INPSEMON REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT j/h�n /zs
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm Yoh�<ee cocj s 5 ar v r c es Co 40 G Phone No. ���� 2 i 2 - 2 Z`(7
Address of Firm _ l (2 'Pr&5 pe--f (fit(l (�'cQ E'4s bUi n m2s�� Zip Code C�6 088
Location of proposed work 33 S'e r e r .
Describe fully nature of permit requested a f e S e r vice
Starting date o r Z Approx.time for completion gY
Call Before You Dig No. Zy I/ S Z O 13 9 / Existing Water Supply: ❑Public Water ❑Well
THE DEPOSIT FOR THE PERMANENExisting Sewage Service: El Public Sewer [I Septic
PLEASE NOTE; T PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,-TRAFFIC CONTROL AND THE TOWNS CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Ir d eate.North Town of South VVindsor
No.cuts
W. a. - 0 L 1 Z o 9( i3 ADD SG Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Se i Ac(I(- s(c rc K
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price
Est.Curb Cost-$.
Est.Traffic Unit Cost$ thr
Est.Traffic Control$
Amt.of Deposit$
Total Due S
{ )Cash ( )Check#
Applicant is responsible for contacting Paid B
the Police t.and C.B.Y.D. y
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-FOWMAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND-WICL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLI ED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date:_
Title: y& - cc),-c f t u(- vr-) T-C Driver's License M
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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`G ''��` �� 211 PE_ 1998
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SELE DR.