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HomeMy WebLinkAboutStreet Cut Permits 763 Griffin Road (2) 1100085 TOWN OF SOUTH WIN PERMIT NUMBER D S O R, C T STREET CUT PERMIT DATE: 07/15/11 GIS ID: 39000763 MUMS APPLICATION# 201100767 "` - = FEE: 25.00 FI'IRATION DATE: 07/14/12 APPLICANT- LOCATION NAME: AJ&J EXCAVATION LZ ADDRESS: 21 CUNT ELDREDGE R?Al� DDRE 763 GRIFFIN ROAD OWE WILLINGTON,CT 0(b4 = GUAIN` HOMES LLC „ " 258 RYE§T PHONE OOK,CT;06016 vit 51 WORK DESCRIPTION: (2)CA $A &PIPE , O DETENfiIOI�P©T�7�ANDS WATER CONNECTION) ME � APPLICANT AGREES TO FURNISH THE TQWft1j- OUTH^ THE TOWN OF SOUTH WINDSOR FOR ANY EXP N IN S Ti CU �Q K-- REQUIRED QUIIRE OR REPAIR TO REIMBURSE CONNECTION WITH THIS PERMIT AND THE A1�PF AA- - FpM IAR WITH A1�TD WJ L ABIDE BY T ERULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF S{)T1TH WINDSRsSY�T, F. CU 3'ERI�IIT MANUAL. ISSUED BY DATE INSPECTED INSPECTED BY 7/15/20112:31PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: ����� CONTRACTOR: LOCATION: %(3 6;r t min TYPE OF WORK: � C ' S p— -A- DATE INSP NEEDED: DATE INSP: INSPECTED BY: WORK IN PROGRESS: 4,0 d e�; C 8 4o Lm L ('v �ye� �✓ti S � o�' � P��s o tn. C'�' S r — mac` J 'r`"�G.- � r✓tn'L 'L� S'J•'�-� ��'LV ti w° rem. SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: L DATE: //A W/2007 Town of South Windsor INPSECTION REPORT 07 APPLICATION FOR STREET EXCAVATION PERMIT 1160 -- Appl. No. TOWN OF SOUTH WINDSOR Permit No. PUBLIC.WORKS DEPARTMENT 1540 SULLIVAN AVENUE Date: ' ) ) SOUTH WINDSOR,CT 06074 FEE $26.00 Name of Firmer T)le- Phone No. 0 Address of Firm('I t" E( r�(�Q 2( 1 " 1 _ T� C7 Zip Code OGa7 g Location of proposed work - '7 63 6 (Z t v=�%N Ptt> - Describe fully nature of permit requested--Cn C*.re-+ ?AS,NS P IPt To k At y f f r Calf/1 PC"rc d iti 0�1 Starting date 7ZYv LY l` Approx.time for completion C;Ly A tj Call Before You Dig No.g9oll a$cS 05L1,5 Existing Water Supply: { rPublic 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_TOWNS-CONTRACT-COSTS.THE-PERMANENT-PATCH-IS-YPICALLY 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) --of Est.Pvt.Thickness in. Est.Patch Unit Price$ /sf Est.Patch Cost$ t Est.Curb Replacement ft Est.Curb Unit Price_$_ /ft Est:Curb Cost$ Est.Traffic Unit Cost$ /hr Is, CPg-PrS . N� -7 Est.Traffic Control$ �o B. To (LI Amt.of Deposit$ e 0ow Total Due$ Cash O Check# Applicant is responsible for contacting O Paid By the Police Dept.and C.S.Y.D. AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR. HE 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 AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: Date•_ 7-1�— Title: o Driver's License#: 07 6 I y 26ig J 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