HomeMy WebLinkAboutStreet Cut Permits 301 Governors highway (2) 1200214
PERMIT NUMBER TOWN OF SOUTH WIN D
SOR, CT
DATE: 11/05/12 = STREET CUT PERMIT
GIS ID:36900301 _
MUNIS APPLICATION# 201201477
FEE:
IL
EXPIRATION DATE: 25.00
APPLICANT- 11/05/13
NAME: AMB SITE DEVELOPMENT LLC '
ADDRESS: 56 SHINGLE MILL RCAF LOCATION
ADDRESS 301 GOVERNORS HIGHWAy
HARWINTON, CT 06�9� - ���� MAY DEPARTMENT STORES
PHONE 111 IN7 �SEVENTH ST
GIlyCINNNTI, OH 45202
WORK DESCRIPTION: INSTAL,-I;NE���CI��'`,
LINE A13O1pVO.
DIAOE ���FROIE W FIBER OPTIC
APPLICANT AGREES TO FURNISH THE 1`gWpgOUTH --
THE TOWN OF SOUTH WINDSOR FOR ANY E PEI - IIVCU '�D b O T OFI34 VD REQUIRED AND TO REIMBURSE
CONNECTION WITH THIS PERMIT AND THE ApILLCANTIS F /
FOR PERMITS AS OUTLINED IN THE TOWI\r pF SOITPI3 WIIyDS t3$Y1TIL`�pWN FORM INTENANCE OR REPAIR WORK IN
AIGII -T4 WLTH ANI)WIE ABIDE BY THE RULES AND REGULATIONS
REET CUTP RI�IIT MANUAL.
ISSUED BY �C
DA. INSIDE TED 4e^�
1 Ii5i20I2 9:I7 AM INSPECTE y
*** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMESAsm
***
Am e
i
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: a Oda? qCONTRACTOR: 6 s, e elo,orwn,
-r—
LOCATION:_ SO y
TYPE OF WORK: vl y''
DATE INSP NEEDED: DATE INSP: 1114 /Z
INSPECTED BY:_ Sb
WORK IN
PROGRESS:_ C' -� �� .c k l c�x .t 20 x 2
Yvc
Foil,
t a � e.1 a Lt,'�til i'►e� 1 r,i °-.�
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C, DATE:__
SjFORMS/TOWN OF SOUTH WINDSOR INSPECTION
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 $25.00
Name of firm `�� �, _'Phone No. Ri66-dam- /&7-
Address of Firm Zip Code Q6!Z21
Location of proposed work ��01 6 ec nom
Describe fully nature of permit requested_.-7,' ,2// A)- .4 t-A.I G =l nf1r LQG ra A
c N t, ��,�
Starting date_Alov 1,_AV0 f 2 Approx._time for completion Wtiv A ran/n?
Call Before You Dig No.,Od&-129 61&61-) Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑Septic
---- - - PLEASE-NOTE;-THE—DEPOSIT-FOR THE PERMANENT-PAVEMENT-PATCH AND CURR-REPLACEMENT IS-A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Jee. a/VaCW No.cuts_-
Est.Patch Size(s)_ c9'A -`/
0� .
��11 sf
Est.Pvt.Thickness in.
Est. Patch Unit Price$_,?�/sf
Est.Patch Cost$ a o
Est.Curb Replacement�ft
Est.Curb Unit Price$ aQ_/ft
Est.Curb Cost
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$ r)
{ )Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police Dept.and C.B.YD.
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 AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: /0 A31 4201Q
Title: Dlv yer Driver's License#: 0944882t39
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED Q�
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08
4"Tel
12-9968 CONDUIT PLACEMENT 51EL 2"Tel
bertech
P2076 to Bldg 4"Tel t
Prt 2 of 4 301 Governors HWY 211E "FT
® Prt not to scale 4"Tel
South Windsor Ct P2076
THESE MAPS CONTAIN CONFIDENTIAL AND Governors Hwy
COMMERCIALLY SENSITIVE INFORMATION
N
Rte 5 North ---0
Rail Road
Traffic Light Pole—>,►t� �
Locate, excavate and Drainage
intercept existing 4" Area 45' s
Conduit approx 20' _ *--15''
from bldg. Place CHH --
_
HYD A
Transformer concrete Sidewalk 5' t_30' L�/,.76
4 j e6 Gv• O'Nk 29'
Macy s I Jewelers lr� n _ '�
Warehouse i 'I L, .a
Mech area '------------- -- �x6�� /7
_ o�0 " o
Macy s 7 Parkll l
Warehouse Lot r 0 .
301 Governors HWY C,� r
South Windsor Ct �
a is- a