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HomeMy WebLinkAboutStreet Cut Permits 12 Pine Knob Drive (2) 1200017 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 03/19/12 GIS ID: 72000012 FEE: MUNIS APPLICATION# 201200259 .00 EXPIRATION DATE: APPLICANT," LOCATION NAME: YANKEE GAS ADDRESS, 12 PINEXNOB DRIVE ADDRESS: 112 PROSPECT HILL RIB ,'Q ER OSTER COTT B&SALLY E EAST WINDSOR,CT 1�6048 1 PIKE SNOB DRIVE AN PHONE 860-292-2242 " �Y7TIT WINDSOR, CT 06074 WORK DESCRIPTION: REPLAGfff`BIt3EI ISO {33� ilI1T APPLICANT AGREES TO FURNISH THE TQWN� OiJTH SIMRTHEA 6UIIT OE�OpD REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANY�XPE�ISI II•ICCJI��j$Y TUWN FOR M_f1INTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FA--- R WITH ANI3 WILI ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SQ[JIITWLIISSR'STREET CU'L'ERMI MANUAL. ISSUED BY '` DATE lI�1SPE D INSPECTED BY 3/19/201211:08AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** =�Jim ,., l TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: l CONTRACTOR: j 6 A .VeP LOCATION .TYPE OF WORK: � ©r1 5 :DATE INSP NEEDED; DATE INSP: r® i �15 INSPECTED WORK IN PROGRESS: 'r�, rrol /✓we7 �c �`f57z //� SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES ❑ NO AS-BUILT: INPUT: `.. DATE: ,D W12007 Town of South Windsor INPSECTION REPORT 07 APPLICATION FOR STREET EXCAVATION PERMIT 1� �'Appl.No. TOWN OF SOUTH WIMDSOR Permit No. ` PUBLIC-WORKS DEPARTMENT '1540 SULLIVAN AVENUE Date: SOUTH WINDSOR,CT 06074 FEE $25.00 Name of Firm qk Phone No. � 5- 0 `" c) Address of Firm � '�!`o � 3 � _ -"�� 4<� Zip Code Location of proposedL f Y Describe fully nature of permit requested Starting date .31 aa ao la Approx.time for completion 6 O j Call Before You Dig No.bra Q 110 1 9 ng Supply. ❑Public Water ❑Well �-----ram Existi Water Existing Sewage Service: 0 Public Sewer ❑Septic PLEASE NOTE-. THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC-CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH 1S TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch of proposed work or furnish two dies of separate drawing This section to be filled out by Irx sate-North Town of South Windsor No.cud Est.Patch Sizes)_� Sf Est.PvL Thickness in. Est.Patch Unit Price$ /sf EsL Patch Cost Est.Curb Replacement ft Est.Curb Unit Price$_ /h EsL Curb Cost#; EsL Traffic Unit Cost 1hr Est.Traffic Control; AmL of Deposit$ Total Due$ { }Cash ( )Check# Applicant is responsible for contacting Palo By the Police Dept.aril 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 1 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS A.S OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL Q Signed: L.1 Date:_ /) - Title: L R " q ,f`Cr, Drivers License#: Q 9 1® 11O 3� 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 Pere it 08 PEv lo-22-m Od 34"2.,,_� a P52o5 E e3 P520 106 06 �/�+y Jr fin.+° 'u, 40 19 Joe Sr`lP C Joe P3445 r � P519 r 4alYDQ t"wN,7`' 7ho material contained on this map shall bo considered prietcry to Yankee Gas and user which fs defined arty an entity who has rece wrd the map through sale,purchase, exchange,rxahange,gift, or f otherwise)shag keep it in confidonce and shall not furnish or disclose it to any thIrd party withesst the prior Contractors mown is not ouaranteed and Yankee Gas assumes no rmoparne i2g. The I�witimt Ul011i�a y5 SIOM written parmrsston of Yankee Gas. Cantroctore are urges to aCM Yankee Gas for further information at t-8(70-919-0900 a e; f e 107 S®Iden St,Berlin C7 s�so t