HomeMy WebLinkAboutStreet Cut Permits 514 Felt Road 1100093 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/25/11
GIS ID: 32400514 FEE: 25.00
MUNIS APPLICATION# 201100787 = E 'IRATION DATE: 07/24/12
APPLICANT` LOCATION
NAME: AIROLDI'S INC. -" = = ADDRESS: 514 FELT ROAD
ADDRESS: P O BOX 71 OWIIER: PEIN 'PETER&LUCILLE A
SOUTH WINDSOR,Gfi 06074 514 F LT ROAD
SUUTH"WINDSOR,CT 06074
PHONE
WORK DESCRIPTION: DRIVEVF� Y
APPLICANT AGREES TO FURNISH THE TDWN OFSOIJT --I-WOR TINE AMOUNT OF BEND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANI EXPIF?�ISE "INCURREDI BY"THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE AI*L- ANT-IS FAMiIAR WIT$AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF IOUTHjVINDSR'S STREET CUT PERMIT MANUAL.
t.,) "/ d 1
ISSUED BY DATE INSPECTED INSPECT D BY
7/25/201111:03AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: / 000 CONTRACTOR:
LOCATION:
TYPE OF WORK:
-DATE INSP NEEDED: DATE INSP:_ i //d z
INSPECTED BY:
WORK IN
PROGRESS: s -�
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES
❑ NO
AS-BUILT:
INPUT: DATE: 0
W/2007 Town of South Windsor INPSECTION REPORT 07
s?oi j DD ? APPLICATION FOR STREET EXCAVATION PERMIT 116')60g3
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm ��e `' S ,-=', Phone No.
Address of Firm Zip Code ®61-')1+
Location of proposed work
Describe fully nature of permit requested =..A =�i�-�,�
Starting date Approx. time for completion
Call Before You Dig No. '�®��3�d���.+*t Existing Water Supply: ❑ Public Water ❑ Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No. cuts
H Est. Patch Size(s) sf
Est. Pvt. Thickness in.
Est. Patch Unit Price$ /sf
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 WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMI OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: ` \ ��`l Date:
Title: G 1114 a\ S �_ 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