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HomeMy WebLinkAboutStreet Cut Permits 496 Rye Street (2) 1200143 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 08/16/12 // GIS ID: 78600496 � FEE: 00 MUNIS APPLICATION# 201201055 EVIRATION DATE: 08/16/13 APPLICANT? % LOCATION NAME: CABLE CONSTRUCTION O II G RES 4§6WYE STREET ADDRESS: 405D NEW STATE RC)J&kfbbfP77? ­r O SOUTH WINDSOR MANCHESTER,CT 00 ' L IgIVAN AVE PHONE _ .. l WNDSOR,CT 060742734 WWI =' WORK DESCRIPTION: REPL% - PROJECT NO FEE APPLICANTAGREFSTORTR THE TOWN OF SOUTH WINDSOR FOR ANC- E' 6 -vI£l�ANTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THI; K �N`UI 1 I wl ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OrU _v _ t� 1 MANUAL. ISSUED BY DAlrfPftPF _ ED INSPECTED BY 8/16/20128:16AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** � �, 3 i {— Wt �5i s £ 'r -� y £• -_36 lmk ON _woo. wit � � N - In ail TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: CONTRACTOR: Q LOCATION: TYPE OF WORK: -GPI Z) 6/1�• DATE INSP NEEDED: DATE INSP: Y ?i INSPECTED BY: 6D WORK IN PROGRESS: c"te- Co t"d-lo a pko e f W t we-pe .d w-d New o► k5 0 ,A 6 4 cy ck` c,�J.rl A SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: G►'� DATE: O �-- S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION APPLICATION FOR STREET EXCAVATION PERMIT Appl. No. TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT 1,640 SULLIVAN AVENUE Date: ly SOUTH WINDSOR,CT 06074 FEE $25.00 // . Name of Firm �� S�� CYO �c� Phone No. 1 E2 C;yI1` Fe?/7 Address of Firm ©S�� A)aw7 G Zip Code Location of proposed work tl �c- Describe fully nature of permit requestedIQ L -a Starting date 1 ' Approx.time for completion •` / / Call Before You Dig No. � fo Existing Water Supply: ❑ Public Water ❑Well Existing Sewage Service: ❑ Public Sewer ❑Septic PLEASE NOTE.—THE-DEPOSIT ERMA NT PATICI+AND-CURB-REPL-AC-EMENT IS " PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT;ItiCLUDING ANY INCREASES IN PATCH AREA,CURB R LENjPTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEA@ OPTHE'TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. 44. • Show sketch of propbsed work or fumish This section to be filled out by two copies of separate draw'drawlig Indicate.North Town of South Windsor No.cuts 4 1 i —ro U)o pr&ec� 0 Est.Patch Size(s) sf ,gyp Est.Pvt.Thickness in. V0 - L Est.Patch Unit Price$ /sf Est.Patch Cost$ Est.Curb Replacement ft 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 CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS A U IN N THE TOWN OF SOUTH WINDSOR'S STREET CUT PER IT MANUAL. Signed: Date: Title: `� Driver's License#: 0C/!Z 9 2Q31& 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 Septic System As- Built Plan Address - c^ C c rl--4a. C_ Date 0. Location of System Fti-6•A1 r�v�C. 0 �� col2e;v S S t od :lam; .(N, S, E,W, front,back side of house) Draft a substantially correct drawing showingseparation distances of the septic system installation. Include all of the following information to provide an accurate record of the entire system location: At least two sides of the building nearest the system, septic tank,house sewer,distribution boxes, trench ends, dry wells,-curtain drain,potable water supply wells and any other features affecting the system and its to Installers Nam Address G S7 ,. ? (street, city,state and zip code) o v� .Z D 1 / �.� ��Fvc � � G 7DP 5. 3 F 'i��tyo B J L04 o Distance from corner A y, -� , 3�• /o i5 Distance from corner B Distance from corner C Distance from corner D 0 a