HomeMy WebLinkAboutStreet Cut Permits 130 Hillside Drive (2) 1100047 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 05/18/11
GIS ID:43800130 FEE: 00
MUNIS APPLICATION# 201100464 EXPIRATION DATE:
APPLICANT` -= LOCATION
NAME: YANKEE GAS = AIDpRESB: 130 HILL SIDE DRIVE
ADDRESS: 112 PROSPECT HILL RD iWTER NQKOTT JOHN K
EAST WINDSOR,C V06088 130 'HILLSIDE DRIVE
- JTH VIINDSOR,CT 06074
PHONE 860-292-2242
WORK DESCRIPTION: INSTALLGARVIC -
APPLICANT AGREES TO FURNISH THE T`OW1-I OF'SOUTH'V II�IDS{IR fH AMOU-NT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPEI�JSES INGU�D BY-THE TOWN FOR-MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPL ANT--IS FAM LIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN PhIM'IT MANUAL.
ISSUED BY DA INSPECTED INSPECTED BY
5/18/201112:02PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: l )60D y 7 CONTRACTOR: V an
LOCATION: 13 l ,L�I� br
TYPE OF WORK: 1 'n Sd W L(_ G a,S _5fr\I I C
lrj
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS: 7' `f,S G,,,+ 4,5 i�s GPIs
r✓�c s�
i c ato PAC
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C DATE:
W/2007 Town of South Windsor INPSEMON REPORT 07
05/17/2011 TUE 13: 05 FAX 860 292 2202 0002/002
d01100V(0 APPLICATION FOR STREET EXCAVATION PERMIT 1foot)y7
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT t- Q
1540 SULLIVAN AVENUE Date: V��U�
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firms 1 r -S Phone No.
Address of Firm �U, t r' Zip Code Q(n,O'k
Location of proposed work f Dr.
Describe fully nature of permit requested 1 Y 11 Ste( QOLJ_ "C�
Starting dated .OF (t'1 r'c"- Q 1 Approx.time for completion I
Call Before You Dig No. c �� 0 j Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND.CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
-L•ENGTH,-T-RAFFIG�-GNFRGL AND-T-HE-TOWN'S CGNTRACT EOSTS:•,T-HE•PERMANENT PAT--GH•1&TYPICALLY
COMPLETED WITMIN-A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be-f!fled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit•Price$ !sf
_ ._.... _. ....... ..._._ ..... ... .._._._. .._.._.._._._._....... .._....._._.....__.
pOSs o Est.Patch Cost$
�.� Est.Curb Replacement ft
Est.Curb Unit Price$ /it
Est.Curb Cost$
Est.Traffic Unit Cost
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
PERMIT OUTLINED THE TOWN OF SOUTH W INDSOR'S STREET CUT PERMIT MANUAL.
Signed: IJ 01(�-L Date;
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