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Home My WebLink AboutStreet Cut Permits 15 Wentworth Drive (2) 1200113 TOWN OF SOUTH WINDSOR, CT PENT NUMBER STREET CUT PERMIT DATE: 06/22/12 �� „ GIS ID: 93300015 FEE: 25.00- MUNIS APPLICATION# 201200826 s ��' EXPIRATION DATE: 06/22/13 APPLICANV-F LOCATION NAME: HOMEOWNER �DRES I *WORTH DRIVE ADDRESS: SOUTH WINDSOR,C 7 /� s J WIS I4ARTIN J&KAREN M jif y ::p VN' WORTH DRIVE IF /� JINDSOR CT 06074 PHONE � WORK DESCRIPTION: REPII7W �L � , APPLICANT AGREES TO FURNISH THE TQVQO fkmuTol f� AMQUIK 0 13 ND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR AN E $ `SZS' 1 � E 142R fAINTENANCE OR REPAIR WORK IN IS CONNECTION WITH THIS PERMIT AND TH ` GAS I W ] �(7I ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF 7i�fi W P IIE IT MANUAL. ISSUED BY A TED INSPECTED BY 6/22/2012 11:58 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** Am s_� _/ 0/ y IF Lin -gw ` i �i - may j 3 j — �� y'y � ! ; - , jai _ y APPLICATION FOR STREET EXCAVATION PERMIT Appl. No. TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT 1640 SULLIVAN AVENUE Date: 2 � - SOUTH WINDSOR,CT 06074 FEE $25.00 Name of Firm i✓+ A . LP Phone No. �t; 2 ga Address of Firm a Zip Code Location of proposed work Des vibe f Ily nat a of permit requested K Starting date b 12, Approx.time for completion 5 Call Before You Dig No. o a a3 o3-y q Existing Water Supply: ❑Public Water ❑Well Existing Sewage Service: ❑Public Sewer ❑Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch of proposed work or furnish This section to be filled out by two copies of separate drawing Indicate.North Town of.South Windsor No.cuts Est.Patch Sizes) sf . Est.Pvt.Thickness in. Est.Patch Unit Price Est.Patch Cost$ Est.Curb Replacement ft Est.Curb Unit Price$ /ft Est.Curb Cost.$, Est.Traffic Unit Cost$ /hr Est.Traffic Control$ A nL of Deposit$ Total Due$ ( )Cash ( )Check# Applicant is responsible for contacting Paid By the Police De A.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 CONNECTI WITH THIS/PERM" ERMIT THAT I AM FAMILIAR WITH AND WILL ABI E BY THE RULES AND REGULATIONS FOR PERMITS I D THE TO OF SOUTH WINDSOR'S STREET CUT Pf R I MA UAL. Signed: Date: Title:m.(c 'n W i/1��"� 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 TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: ©I/ CONTRACTOR:- RD Yv-Po LZ �`- LOCATION: 1.S� Lk e VA-k-u n CA3r 1� TYPE OF WORK: KD-4 O i Q. 0 0-0-t �a ItiQ� DATE INSP NEEDED: DATE INSP: INSPECTED BY: as WORK IN PROGRESS: 4--, f 1 rl P k.eonA AS-BUILT: INPUT: C � DATE: W/2007 Town of South Windsor INPSECTION REPORT 07