HomeMy WebLinkAboutStreet Cut Permits 329 Brookfield Street (2) 1200001 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 01/18/12 =
GIS ID: 14700329 FEE: 25.00
MUNIS APPLICATION# 201200044 EIRATION DATE: O1/17/13 XP
APPLICANT - - LOCATION
NAME: TELE-NETWORKS
ADDRESS- 329 BROOKFIELD STREET
ADDRESS: 31 BAKEWELL COURT OWNER: DEM G_DIANE P
CRASTON,RI 02921 32 'BROKFIELD STRE
SOUTH WINDSOR,CT 06074
PHONE 401-461-8420
WORK DESCRIPTION: INSTALS REPLY CAfV
APPLICANT AGREES TO FURNISH THE T OwN-_ F SOUTH WINDSOR TIIE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANXF�k NSE3 IN T B-'THETQWN N'4AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE taPPL1CAT IS FAMILIAR WITH AND WIT L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSR'S STRE11-CUT PERMIT MANUAL.
ISSUED BY DATh INSPECTED INSPECTED BY
1/18/2012 10:28 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
................. ... ......... ........................... -- __
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: R 06 QOIVI'RACi1DR: �Z"/ V /l�E'J �
. LOCATION: Aq �
TYPE OF WORK:_
_DATE INSP NEEDED; DATE INSP:�s
INSPECTED BY: rib .
WORK IN
PROGRESS: Ldv,-vc
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
'AS-BUILT:
INPUT: DATE:—a
W/2007 Town of south Windsor INPSEMON REPORT 07
APPLICATION FOR STREET EXCAVATION. PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: 1-0ot
SOUTH. WINDSOR,CT 06074
ram, FEE $25.00
Name of Firm Qe�e' Wockc_.� Phone NoA. 81 $(41;. z C�2.
Address of Firm (' wa. w h Zip Code dZ.miO 3
Location of proposed work is"010R^W ST,
Describe fully nature of permit requested� AIN
Starting date Approx.time for completion \ `f
Call Before You Dig No.&O} 5301 1 Existing Water Supply: 0 Public Water ❑Well
Existing Sewage Service: E Public Sewer El Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS.RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL.AND THE TOWN'S`CONTRACT COSTS: THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR,'OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This potion to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
�fe ac�2
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
- I
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Arnt.of(Deposit$
Total Due$
)Cash O Check
Applicant is responsible for contacting Paid By
the Police De t.and C.S.Y.D.
1 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 PERMITAND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMIT T1,1111D THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
igned: o-- Date:
(-v
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 JOBSITF AT ALL TIMES
Street Excavation Permit 08 REV.10-22-08
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24/28 54/37
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RG6
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Map data 02011 Google-
http://maps.google.com/maps?hl=en&tab=wl 1/9/2012