HomeMy WebLinkAboutStreet Cut Permits 85 Skyline Drive 1100063 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/21/11
GIS ID: 83100085 FEE: 25.00
MUNIS APPLICATION# 201100633 - EXPIRATION DATE: 06/20/12
APPLICANT = LOCATION
NAME: AIROLDI'S INC. =- - ; A OVEDDRESS:` 0 SKYhINE DRIVE
ADDRESS: P O BOX 71 R = BEATKIVAGE GENEVIEVE M
SOUTH WINDSOR, T 06b74 ; ; 85'SKI'LINE DRIVE
$OUTHVINDSOR,CT 06074
PHONE
WORK DESCRIPTION: DRIVEVrAY
APPLICANT AGREES TO FURNISH THE TOWN-OF SOUTH WIND-9OR'i'HE AMOUNT OF--BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPANSES INCU"---ED-SY TIIE TOWN FOR 3 AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICARfi IS AMID V-1--T AN)WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOiJTH TDR'SfiET f ---MIT MANUAL.WI
C Ift//0
ISSUED BY DATE 'SPECTED INSPECTED BY
6/21/201111:36AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
QQ '
PERMIT NO.: // D OBE CONTRACTOR: j CO
LOCATION:
TYPE OF WORK: v c4o Q
DATE INSP NEEDED: DATE INSP: / Z
INSPECTED BY: g N
WORK IN
PROGRESS: fit
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES [:] NO
AS-BUILT:
INPUT: C� 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: \\
SOUTH WINDSOR, CT 06074
_ FEE $25.00
Name of Firm ����� s �'� Phone No.
Address of Firm' _o-,z Zip Code
Location of proposed work 4S 4�9\-- �.
Describe fully nature of permit requested
Starting date ZB \ Approx. time for completion
Call Before You Dig No. Existing Water Supply: ❑ Public Water ❑ Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA; CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
0
Est. Patch Size(s) sf
`l.b Est. Pvt. Thickness in.
la � v°g� Est. Patch Unit Price$ /sf
Est. Patch Cost$
�p 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: ���J ��.ac\�ta� Dater\3\\
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
Street Excavation Permit 08 REV 10-22-08