HomeMy WebLinkAboutStreet Cut Permits 9999 Avery Street (14) 1200054 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 04/18/12 "
GIS ID: 06309999 - — FEE: 25.00
MUNIS APPLICATION# 201200436 =, -; = E 'IRATION DATE: 04/18/13
APPLICANT, ;; LOCATION
NAME: BARBER UTILITIES LEG— 1�DRES AyERY STREET
ADDRESS: 35 PINNACLE ROAD — WNEI I(3WN O SOUTH WINDSOR
ELLINGTON,CT 06029� " 54P§01-1IVAN AVE
11 SOCTMWINDSOR,CT 06074
PHONE
WORK DESCRIPTION: WATER MAIN t N S I2�I'CL AVBNWhOGHT- I'HA-E II
APPLICANT AGREES TO FURNISH THE TWNtOFOIJTHWONSpR��4MOUTTT OI $OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANIPE�1SE INCIJR�I3T11E TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT I,S FIILTIANYD WIC L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SI?UL4 WINI3SR3S=TRE CUT-PERMIT MANUAL.
ISSUED BY DATE"INSPECTED INSPECTED BY
4/18/2012 11:36 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMESAR
***
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TOWN OF SOUTH WINDSOR WSPEMON REPORT
PERMITNO.: •/& OONTRACioR:,_� � h
LOCATION: IA\342-,(A <°l-
. ?YPE OF WORK: l [� II a;11 d, I C
:DATE INSP NEED: DATE INSP: Z�Ilz
I1VSPf_-CTM BY: 1,.
-WORK IN
PROGRESS: "a
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED Q YES Q N4
AS-BUILT:
INPUT: DA7"E.__wS9lLLi
W12007 Town of SoA Windsor INPSEmON REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl.No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC.WORKS DEPARTMENT
•1640 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name.of -irm— -_ > -1 _ - Phone No:
Address of Firm 6 If QX 33( 62_4 A--*& Zip Code 8
Location of proposed work
Describe fully nature of permit requested r ,� r SE2yi G£S
Starting date Approx.time for completion • 30 ads
Cali Before You Dig No. 2 Z /SO 0 f Existing Water.Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE; THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
{LENGTH,TRAFFIC.CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
-Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing indicate North Town of South Windsor
No.cuts
L CD PQl/Lj I .. Est.Patch Size(s) sf
.. �v��J ql „I�� ��� - Est.Pvt.Thickness in.
Id-� Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$.. ift
Est:Curb Cost-$.
Est.Traffic Unit Cost$ Mr
Est.Tmfflo Control$
Amt.of Deposit$
Total Due$
j Cash ( j Check#
Applicant is responsible for contacting 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 TH THIS PER AND THAT 1 AM FAMILIARVITH AND WILL ABIDE BY THE RULE_S AND REGULATIONS FOR
PERMITS AS INED IN TH T N OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: ` —!�-
Title_: O wtiC'YL- 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.