HomeMy WebLinkAboutStreet Cut Permits 96 Tumble Brook Drive (3) 1200068 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/04/12
GIS ID: 90600096 FEE: 25.00
MUNIS APPLICATION# 201200529 IyIRATION DATE: 05/04/13
APPLICANT .,LOCATION
NAME: HOMEOWNER ADTS 96 SUMii,E BROOK DRIVE
ADDRESS: SOUTH WINDSOR, CT 66Z4 OWF RiwGORY D&
%�„ 76 t1VFRY ST
SaUTI�W1 DSOR,CT 06074
PHONE ,,
WORK DESCRIPTION: REPLACE 2 SII I WALK I NE1' 3 O V ED FOR 1 P&PERMANENT
ELECT IC-S VIC '- ""'
APPLICANT AGREES TO FURNISH THE T0W1V OFOUTf1 WINDQIIfi UNTTSF BN17 REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANft)XPENSES INCURREII BYTHE TOWN 1( ]SIATNTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE AI'PLICINT IS FAMIAR WITHNb V4I L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WII -SR S STREE CUT FERMI MANUAL.
^C3 r to ,
ISSUED BY D- E INF,CED` INSPECTED BY
5/4/20128:55AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
„ - ,.
TOW?l OF SOUTH WINDSOR INSPECTION REPORT
_ - PERMTfNO; 1 d-t)Dc* OONTRACrM, G Z rt
LOCATION' (n �m�l
TYPE OF WORKL��� ►c P� �V� s
:DATE INSP NEED®: DATE
INS!'C-CFkU 6Y:
-WORK IN
Pa�GR D� r-e-
SEMC TANK PUMPED,SMASHED,FILLED WITNESSED Q YES Q NO
•AS-BUILT:
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•. rmPUT: C� • .
DATE:
W12007 Town of South Windsor INPSBMON REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
'1540 SULLIVAN AVENUE Date: •7:"f '
SOUTH WINDSOR,CT 06074 ,.
FEE $25.00
Name of Firm 0 C&g Phone No. ��d_ ` 8 �'"� S`�cp
Address of Firm 2 3 u g&&I Lida Zip Code NQ O 7�_
Location of proposed work tx tck L1 to I2 p f— S W g�r
.Descritn fully nature of permit requested
+ e J;
Starting date 'S-:3 -l_2., Approx.time for completion
Call Before You Dig No. Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT-PAVEMENT-PATCH-AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH;TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORAgY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing v)�,�k-Indicate North Town of South Windsor
No.cuts
SCR Est.Patch Size(s) !� sf
Est.Pvt.Thickness in.
x. 1K Est.Patch Unit Price
Est.Patch Cost$
P ( Est.Curb Replacement ft
I Est.Curb Unit Price_$. /fit
`A Est.Curb Cost.$.
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
( Total Due$ `
i O Cash O Check#
Applicant is responsible for contacting ( Paid By
the Police Dept.and CB.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 Ay INED i TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: C Date: -7f&'4-0' j
Title: �� � S 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