HomeMy WebLinkAboutStreet Cut Permits 35 Chapin Street (2) 1100116 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/11/I 1
GIS ID: 18200035 FEE: 25.00
MUNIS APPLICATION# 201100895 $ PIRATION DATE: 08/10/12
APPLICANT_ = LOCATION
NAME: QUALITY PAVING CO - _�ADDRESS.:= 35 CHAPIN STREET
ADDRESS: 194 S.MAIN STREET - OWNER: SCHUSIR DEBRA A
EAST WINDSOR,CT 06088 35 CHAPIN ST
SflUI WINDSOR,CT 06074
PHONE 860-523-4182 -
WORK DESCRIPTION: DRIVEWAY -
APPLICANT AGREES TO FURNISH THE TOWN-,OP SOUTH-WINDSOR TI4E-AMOlik OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY'EXPENSES INCt)RR�D;BY THI TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE API'LICANTJS FAMII IAR WITH AN1-WIIL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINI-SR'S STREET CUT PERMIT MANUAL.
Cl
ISSUED BY DATE INSPECTED INSPECTED BY
8/11/201110:52AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: r 00 CONTRACTOR: Q / c
LOCATION• n
TYPE OF WORK: D 6 v�-Q wo u
DATE INSP NEEDED: DATE INSP: i1 z
INSPECTED BY: t n
WORK IN
PROGRESS: t o'_z
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
-71
INPUT: DATE:
W/2007 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 $25.00
Name of Firm44011aiD/jU& hone No.
Address of Firm zip Code Q
Location of proposed work
Descr'be fully nature f rmit equested
z — z417
Starting date 8 �/ Approx.time for completion
Cali Before You Dig No. Z0/ 320 Z z Existing Water.Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH;TRAFFICCONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North town of South Windsor
No.cuts
o Est.Patch Sizes) sf
9240
Est.Pvt.Thickness in.
/ Est.Patch Unit Price$ /sf
Est:Patch Cost$
7i Est.Curb Replacement ft
Est.Curb Unit Prise-$. rft
Est:Curb Cost$
Est.Traffic Unit Cost$ Jhr
r Est.Traffic Control$
AmL of Deposit$
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
CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS A OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed- Date•
Title: Driver's License M
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT? n WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED -��-�/''�
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES � I
Street Excavation Kermit 08 REV 10-22-08 ��� '•+ � t