HomeMy WebLinkAboutStreet Cut Permits 9999 Peach Drive (2) 1100159 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 10/04/11
GIS ID:99997010 FEE: 00
MUNIS APPLICATION# 201101164 E 'IRATION DATE:
APPLICANT `" - .-" LOCATION
NAME: YANKEE GAS ADDRESS: 9999 PEACH DRIVE
ADDRESS: 112 PROSPECT HILLRD OWNER: TOWL(7F SOUTH WINDSOR
EAST WINDSOR,CT 064N8 140 SULLIVAN AVE
SOUTH V INDSOR,CT 060742734
PHONE 860-292-2242
WORK DESCRIPTION: REPLAC WHS ON"tiA MAIN
APPLICANT AGREES TO FURNISH THE T`OW1SL OF SOUTH W�NDS(3i2- AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANIEPINSES INCURRED BY,THE TOWN*OR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THff IPPUCANTIS FAMIILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OFF IJTH WINDSR--S STREETCUTPERMIT MANUAL.el
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ISSUED BY DATE—* TED INSPECTED BY
10/4/201112:07PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I ] 001 S `j CONTRACTOR: Y_cZ Ya hw (�1
LOCATION:
-'TYPE OF WORK: as Yrl o,1 IV
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DATE INSP NEEDED: DATE INSP: I 3 /
INSPECTED BY: Rb
WORK IN
PROGRESS: Al
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
'AS-BUILT:
INPUT: �l DATE: Lax
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 Dater
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm V(avt k e,a —(;,qs Phone No. (3 - C)
Address of Firm It A , f rc? ert t Zip Code o h Q 7s?'
Location of proposed work pe- f► near
Describe fully nature of permit requested ��P lam e_ L�O�'�� -�t 5 /►�� `n
Starting dat® t Approx.time for completion c� g•.� S
Call Before You Dig No. O It L 00S 0 Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑Public Sealer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC.CONTROL AND THE TOWNS CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed Work or fun-dsh This section to be titled out by
two copies of separate drawing Indicate.North Town of South Windsor
0 No.UJIS
Est.Patch Sizes) sf
- Est.Pvt.Thickness In.
Est.Patch Unit Price$ /sf
Est.Patch-Cost$
Est.Curb Replacement ft
Est Curb Unit Prices /ft
EsL Curb Costa
Est.Traffic Unit Cost$ fir
EsL Traffic Control$
AmL 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 AS OUTLINED IN-THETOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed. Date: 1
Title. L e 6 e re Driver's License#: O 16 q.10 4 0 �j
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
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The material contained on this map C
shall be considered proprietary to Title,
Yankee Gas and user(which is
defined as any parson or entity pmcl�
ho has reaeived tha map througsalexcManga, gift,or
atherwf9e)shaFl keep i#in confidence
and shall not furnish or disclose it r-----•.-
to Ony third porky without the Prior intornlotion shown is not puarontend and Yankee Gas aaeumee no responsibility, The Np►#f1eg5#U#1iliC5 System
written permraa+on of Yankee Gas. Contractors are urged to calf Yankee Goa for further Information at 1-soo-8 9-0900 0 8, y
P— 107 Selden St.,Berlin CT 06037
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The material contained on thia mop
shah be considered proprietary to Title,
fanned Got
and user(which u1
defined as any penort or entity
who has reeewed the map through
axle,purchase, exchange,gift,or
otherwise)shall keep it in confidence 1 444 "��JJ 7+»✓ "`^^. ......���
and ahall at furnish ar dieciaae it
to any third party without the prior Information ahawn is not quoronteed and Yankee Goa aseumaa no responamlQty �"'""�"" 7ht? NOrlhedsl Utlilies sysltf<n
written permission of Yankee Gas. Can traalora are urged to salt Yankee Gas for further Information at i+R00—® 9-0800 0 6• gp�
107 Selden St.,Berlin 0T 0037
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