HomeMy WebLinkAboutStreet Cut Permits 44 Simcka Drive (3) 1200198 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 10/11/12 4
GIS ID: 82800044 � � g FEE: 25.00
MI JNIS APPLICATION 1341 PIRATION DATE: 10/11/13
APPLICAN E LOCATION
NAME: MARTIN LAVIERO C T R $CTO DRE 4 l SIMVI DRIVE
ADDRESS: 611 NORTH MAINS i E GaHE VIRGINIA R
P O BOX 1659SC" DRIVE
BRISTOL,CT 06010 INDSOR,CT 06074
PHONE 860-589-7579 v
vow
WORK DESCRIPTION: RE A L R MDC
APPLICANT AGREES TO FURNISH THE D REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR OR AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TH IS L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN O T MANUAL.
ISSUED BY DA7 TED INSPECTED BY
10/11/2012 11:16 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: O CONTRACTOR: d Lv),�
LOCATION:_ 1 V1(t _
TYPE OF WORK:— e4r
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:
7—
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: � � DATE: Ia2-
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
10/09/2012 TIE 8:37 FAX 210 349 2464 ERCC OFFICE Ia001/001
APPLICATION FOR STREET EXCAVATION PERMIT
.Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: s iCJ�
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm Martin Laviero Contractor Inc. Phone No. 860-589-7579
Address of-Firm 611 North Main Street Bristol, CT Zip Code 06010
Location of proposed work 44 Simka Drive
Describe fully nature of permit requested remove and replace two sidewalk slabs
Starting date Approx.time for completion
Cali Before You Dig No: -20124003704 Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR.THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT;INCLUDING.ANY INCREASES IN PATCH AREA,CURB_
-1LENCITH,TRAFFIC CONTROL AND THE TOWNS CONTRACT C05TS. THE PERMANENT PATCH IS TYPICALLY
'COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
-Show sketch of proposed work or furnish i�sec>�on�be fOhd out by
two copies of separate drawing lntllcate North Town of Sphuth Wtncteor
No.cuts
"see attached drawing" Est Patch Sixes) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price
` Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ !ft
Est.Curb Cost$
Est.Traffic Unit Cost$ fir
Est.Traffic Control$
Amt.of Deposit$_-
Total Due$
( )Cash ( )Chock*__
Applicant is responsible for contaeft Paid By
the Police Dept.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
CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH.AND WILL ABIDE BY Till=.RULES:AND REGULATIONS FOR
PERMITS A&O TLIN I T WN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
TIN=
Signed: Date: ,A)"'l�
Title: 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
THE METROPOLITAN DISTRICT - PAVEMENT CUT DATE:
BILL,JOB YES❑ NO 2'� WO#
ADDRESS � TOWN '" STATE HIGHWAY YES ❑ NO L
. "p •.
DRAW SKETCH SHOWING LOCATION AND SIZE OF CUTS AND CUT MADE IN
CROSS SECTION OF PAVEMENT
r� STREET BIT. CONC. ❑ CrQNCRETE ❑ PREMIX ❑
--� SIDEWALK �'� BIT. CONC. ❑ CONCRETE L FLAG ❑
CURB BIT. CONC. ❑ CONCRETE ❑ STONE ❑
DRIVEWAY BIT. CONC. ❑ CONCRETE ❑
GRASS LOAM &SEED NEEDED YES ❑ NO L
REASON FOR CUT:
NUMBER OF CUTS:
DATE OF FIRST CUT:
�. IS JOB COMPLETED: YES�!r NO❑
FOREMAN:-4
6o "" ""�"" �C� vf �. REPLACEMENT PAVEMENT CONTRACT NO.:
BIT. CONC. ElCONCRETE ❑ PREMIX ❑
..._.._.. _.. W __.., . �. __._....... r' ,_ _�f ..� �. .._.,.. _... ....._^ DATE COMPLETED:
rr ACCOUNT NUMBER: f
CALCULATIONS
OF CUT ITEM# ! ITEM# ITEM#_ TI EM#
PRESS HARD 3 COPIES PAVING INSP. OPERATIONS UTILITY SERVICES CONTRACTOR
(ORIGINAL) (WHITE) (WHITE) (YELLOW)
-Molloy, Catherine
From: Cal[Center@CBYD.com
Sent: Friday, October 05, 2012 11:53 AM
To: CBYD
Subject: Locate Request-20124003704
(CALL BEFORE YOU DIG CT) 10/05/2012 11:53:11
-5G -C1 -GV -OT
3-SW SWINDS -T5 -W3
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*** REMOTE BATCH ENTRY ***
***** ROUTINE ***** vo
TIME. .11:52 DATE. .10/05/2012
REQUEST NO. . .20124003704 I `� CAD
LATITUDE. .41.8152095 LONGITUDE. .-72.5875419
TOWN. . . . . .SOUTH WINDSOR y
ADDRESS. . .44
STREET. . . .SIMKA DR
NEAREST
CROSS STREET. .NORTHVIEW DR
-----------------------------------------------------------------
TYPE OF WORK. . . . .REMOVE & REPLACE SIDEWALK
AREA IS MARKED. . .YES //� ✓
REMARKS: V�
MDC SIDEWALK REPLACEMENT
--------------------------------------------------------------------------
START DATE. . . . . .10/11/2012 START TIME. .07:00
CALLER. . . . . . . . . .CAITLIN
CALL BACK. . . . . . .8-5
PHONE #. . . . . . . . .860-589-7579
FAX #. . . . . . . . . . .860-585-6651
ALT. PHONE #. . . .
EMAIL ADDRESS. . .
CONTRACTOR. . . . . .MARTIN LAVIERO CONTRACTOR & CORP
ADDRESS. . . . . . . . .611 NORTH MAIN ST
CITY. . . . . . . . . . . .BRISTOL
STATE. . . . . . . . . . .CT
ZIP. . . . . . . . . . . . .06010
------------------------------------7-------------------------------------
EXCAVATOR DOING WORK. .MARTIN LAVIERO
ISSUED TO: DATE: TIME: BY:
DATE/TIME ARRIVED: TIME LEFT: COMPLETED BY:
CALL BACK: 1) DATE: TIME: BY: 2) DATE: TIME: BY:
PERSON CONTACTED: PERSON CONTACTED:
1