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HomeMy WebLinkAboutStreet Cut Permits 20 Pam Lane (2) 1100158 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 10/04/11 GIS ID: 68700020 FEE: 00 MUNIS APPLICATION# 201101162PIRATION DATE: APPLICANT - = LOCATION NAME: YANKEE GAS ADDRESS: 29 PAM- ANE ADDRESS: 112 PROSPECT HILURIX , f ,6RCORAN DANIEL J&SHIRLEY EAST WINDSOR,CT 0688 �I),PAM LANE wn- SOU WINDSOR,CT 06074 PHONE 860-292-2242 = WORK DESCRIPTION: REPLACE TE ST BOX O—GAS"MAIN APPLICANT AGREES TO FURNISH THE TC)W�OF SOUTII V-fI St}R'f-4T AMOiJI T-GF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR AN 'EX-ENSES INCUI RI<D Bl THE-TOWN'PUR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THi APPLICANT NS FXKftIAR WITH"AND WII L ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN IOF SQ JTH WINDS R,&si`REE'T'CUI.PE�MIT MANUAL. ISSUED BY DATE INSPECTED INSPECTED BY 10/4/201112:12PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** ......... TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: ,I OOI J CONTRACTOR: LOCATION: 0 .TYPE OF WORK: 6 1*/)v DATE INSP NEEDED: DATE INSP: INSPECTED BY; gt� WORK IN PROGRESS: �4 X ,�, t, ;v�i /►? �� �j.« �es�- . Tee la 4J-e4,, e SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO 'AS-BUILT: INPUT: DATE: 2_(o W/2007 Town of South Windsor INPSECTION REPORT 07 APPUCATIQN FOR STREET EXCAVATION PERMIT bo/�� Appl.No. TOWN OF SOUTH WINDSOR Perruit No. PUBLIC WORKS DEPARTMENT 1640 SULUVAN AVENUE Date: SOUTH WINDSOR,CT 06074 FEE $25.00 Name of Firm 'I q�i r°C4.a G-a S Phone No. ® "�'�0 -�9d 7 Address of Firm_(1_I ,�_ i're _�A�e-F t{r`19 ►�4� E +,0° s�.^ �� Tip Code -0-6 a�� Location of proposed work a o P A m L n Describe fully nature of permit requested Starting date !A/,�1 a o i 1 Approx.time for completion .3 .) S Call Before You pig No._a.-0 i i 4r0 a a 3 S��' Existing Water Supply: ❑Public Water Q Well Existing Sewage Service: ❑Public-Sewer ❑Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINALCOST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC.CONTROL AND THE TOWN-S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. -Show sketch of proposed work or furnish This se6don to be filled out by two copies of separate drawing Indicate North Town of South Windsor No.rues Est.Patch sizes} sf Est.Pvt.Thickness in. at Patch Unit Price$ /sf Est.Patch-Cost$ Est,Curb Replacement It Est.Curb Unit Pricel~_ /ft Est,Curb Cost-$ Est,Traffic Unit Cost$ fir Est.Traffic Control Amt.of Deposit; Total Due S ( )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 AQ OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signned: e-, Date: O 3 o II Title: L a b o 4-v- Driver's License#. a 2 6 9 14' ')0 y 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 i P3648 �,5 I NOTE, ) �� NORrN OIMOR EN ROM S. OF OARAQ is `V e � 64 29 SriP M, 196Q 127 0� rrs sos, �s P3617 ra �0 y 1:495 1��7s,A 7o,G The material contained on this mop shall be considered propristory to I t I!?: Yankee Gas and user(which is \dho ha os any perhan or entit �-Aft �pwha has rscewed the mop through I�j tc.._...... ES sale,purchase,exchange,gift,or otherwise)shall keep it in confidence and shall not furnish or disclose it information shown is not guaranteed and Yankee Gas assumes no responsibiltt. """" ' The Northeost UtNtles System to any third ppaarty without the prior Contractors are urged to toll Yankee Got for further inrcrnnation at f—s00—s�'+a-0900 0 e; ep— j S9�Seldom St.,Berlin CT 0693 written parrrfitsion or Yankee Gas. i �I a e'+ 12 �tQ 1g6fl II P3618 NOrE. ©IM NORTH G TAKEN FROM a?NER OF GARAGE s 64 Sr 127 a. y1.J 196p Spy, �s P3617 m a hOF t:4Y5 t•-as,4 7o,t The material contained an this map i I ; shall be considered proprietary to Yankee Gas and user(which Is n \ defined as cnyy person a anhrou h �/� p ` who has received the map Oft or 11 ` sale,purchase,exchange,gift,deuce otherw'use7 shall keep it in confidence ,1 and shall not furnish or disclose it Information shown Is not guaranteed and Yankee Gat aeaumes no responeihility '^'"'"°" I The '`orthlGSl tlttiES System to Cry third fiorty without the Prior Contractors are urged to call Yankee Got for further tnformotron at 1-800-9 9-a900 0 e; - ®p- 107 Selden St.,Berlin CT 06037 written permission or Yankee Gas.