HomeMy WebLinkAboutStreet Cut Permits 164 Graham Road (2) 1100016 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 04/01/11
GIS ID: 37500164 FEE: 25.00
MUNIS APPLICATION# 201100221 EXPIRATION DATE: 03/31/12
APPLICANT LOCATION
NAME: AIROLDI'S INC. ADDRESS: 164 GRAHAM ROAD
ADDRESS: P 0 BOX 71 OWNER: OUELLETTE ROGER
SOUTH WINDSOR,CT 06074 164 GRAHAM ROAD
PHONE SOUTH WINDSOR,CT 06074
WORK DESCRIPTION: DRIVEWAY
APPLICANT AGREES TO FURNISH 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 THE APPLICANT IS FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSR'S STREET CUT PERMIT MANUAL.
ISSUED BY DATEINSPtCTED INSPEC ED BY
4/1/20113:40PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I 00 CONTRACTOR: /Al (0
LOCATION: l c m r`
TYPE OF WORK: ) (A)& j
DATE INSP NEEDED: DATE INSP: , I
INSPECTED BY: 6
WORK IN
PROGRESS: D o f�0
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: 02
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR
PUBLIC.WORKS DEPARTMENT P*ep it No.
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Na
me of Firm
d Phone
.Address of Firm � Zip Code DSO
Location of proposed work�l�
Describe fully nature of permit requested G/
Starting date I C7 -
Approx.time for completion �_
Call Before You Dig No. Existing Water Supply: ❑Public Water
''T-- ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE:.THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
-PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH;TRAFFIC.CONTROL AND THE TOWNS CONTRACT COSTS. THE PERMANENT PATCH IS ICALLY
COMPLETED TYP WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
-Show sketch of proposed work or fumish
two copies of separate drawing This sectlon to be filled out by
Indicate.North n of South Windsor
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
I Est.Patch Unit Price
Est:Patch.Cost$.
Est.Curb Replacement ft
Est.Curb Unit Price.$.. /ft
Est:Curb Cost$
Est,Traffic Unit Cost
$ r m
Est.T raffle Control
$
Amt.of Deposit$
K/ Total Due S
{ )Cash- ( )Check
Applicant is responsible for contacting Paid By-
the Police 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 PERMIT AND THAT i AM FAMILIAR-WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLI D N THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed• Date
Title: _ Dri ees 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
I