HomeMy WebLinkAboutStreet Cut Permits 71 Quarry Brook Drive 1200008 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 02/21/12
GIS ID:74100071 FEE: 25.00
Jr
MUNIS APPLICATION# 201200152 = EXPIRATION DATE: 02/20/13
APPLICANT LOCATION
NAME: JDC ENTERPRISES IIC A-DDRES 71 QJARY BROOK DRIVE
ADDRESS: 420 JOHN FITCH BLED fER. PLATTERS ALAN M&TERESA A
'
PO BOX 905 ,- ?I QUARRY BROOK DRI
SOUTH WINDSOR, CT-40J4 ; ; SOVT I INDSOR, CT 06074
PHONE
WORK DESCRIPTION: EMEGCE'AIROR BROKEN SEWERATERt
APPLICANT AGREES TO FURNISH THE 7rQW&VF=SOUTH)M- MORE€ AMOUNT OR BESND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANIE1 I�1ES INCUI3J$ ;TI=1_TQWNORIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE PPI BAN RIS FAML�IAR WI lH.kN WIZ ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S!?UTH WIND R S"S EET CUT PEI�IVIIT MANUAL.
ISSUED BY DATE-INSPECTED INSPECTED BY
2/21/201210:46AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
AF
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 7 CONTRACPOR: J)C
LOCATION 4(1)el-
TYPE OF WORK:
'DATE INSP NEEDED; DATE INSP...Az-,z
INSPECTED BY:_ LS
WORK IN
PROGRESS:—�2�C a .J Ter
t AI
SEPTTC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑ NO
'AS-BUILT:
INPUT:
DATE:
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 Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm �`Y�i° i/S t� Phone No dW A;
.Address of Firm l- O, 60�-, C,9_ Zip Code O(v 07 y
Location of proposed work l,7/
Describe fully nature of permit requested_ le pe -2
Starting date Approx.time for completion
Cali Before You Dig No.e:I c; Existing Water.Supply: ❑Public Water ❑Well
Existing Sewage Service: [9,Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST.OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH;TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section tope filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cats
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price,' /sf
Est.Patch Cost$
Est.Curb Replacement it
Est.Curb Unit Price$. /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
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
CONNECTM WITH TH PERMIT AND THAT 1 AM FAMILIAR-WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMI A N IN THE TOWN SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date•
Title: 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 JOBSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08.