HomeMy WebLinkAboutStreet Cut Permits 125 Ridgefield Drive (2) 1100073 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/28/11
GIS ID: 75900125 FEE: 25.00
MUNIS APPLICATION# 201100672 EXPIRATION DATE: 06/27/12
APPLICANT - - - LOCATION
NAME: AYOTTE BROTHERS CONST. CO INS „ ADDRESS: 125 .IDGEFIELD DR
ADDRESS: P O BOX 498 OVER: ALBERT-KAREN L
SUFFIELD,CT 0607g 125 RIDGrEFIELD DRIVE
SOUTH VVINDSOR,CT 06074
PHONE 860-654-1800
WORK DESCRIPTION: DRIVEWAY ="
APPLICANT AGREES TO FURNISH THE!'OW--N-OF-,SbUTI-l-Wi]46S-OR-T--H-E AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY=EXPENSIyS INCURRED$ THE TO- N"P4R MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMILIAL WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSR'S'STR$ET CUT.PE --IT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
6/28/20119:46AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I \ 0 0 O j CONTRACTOR: 'A u oTfi(f
LOCATION: G_ 'j a P Lew4
TYPE OF WORK:_ _D P.�,Qa
DATE INSP NEEDED: DATE INSP: / bi ��z
INSPECTED BY: tab
WORK IN
PROGRESS: >�.
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED [-] YES ❑ NO
AS-BUILT:
INPUT: u \ DATE: � I r
W12007 Town of South Windsor INPSEMON REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT 110007,3
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm -_ C-- Phone No.
Address of Firm • C, V 9 Wit- Zip Code 19 (o D 7
Location of proposed work )dr)R L..& ,_n f-2/) It, - W-,d•a---i
Describe fully nature of permit requested Q&.A._.p +422,A2e 6&1.1e CaAa-1- .
Starting date �0 - 3 D- // Approx.time for completion -2-o
Le s
Call Before You Dig No. it p �.. Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
o)o Est. Pvt.Thickness in.
1
Est.Patch Unit Price$ _ /sf
Est.Patch Cost
Est.Curb Replacement ft
r — Est.Curb Unit Price$ /ft
J9 Est.Curb Cost$
I
Est.Traffic Unit Cost$ /hr
war, 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
PERMITS A UTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: 1o.ZL�zl :!�O
Title: nx-a t4 e,:7t 1 e�2 ke in au,,14, Driver's License#: A(//
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