Loading...
HomeMy WebLinkAboutStreet Cut Permits 179 Trumbull Lane (2) 1200134 PERMIT NUMBER TOWN OF SOUTH W I N D S O R, CT DATE; 07/30/12 STREET CUT PERMIT = - � -_ GIS ID: 90200179 - MUNIS APPLICATION# 201200990 FEE. EXPIRATION DATE: 25.00 APPLICANT - 07/30/13 NAME: TELE-NETWORKS LOCAT_ ADDRESS: 31 BAKEWELL COURT = ADDRESS. 11 FRiMBULL LANE CRASTON,RI 02921 = ©W*TER PITRUZELLO STEPHEN M&KATHRYN PHONE - I7 UIyIBULL LANE 401-461-8420tI3ITH INDSOR, CT 06074 WORK DESCRIPTION: REPf, D APPLICANT AGREES TO FURNISH THE T-D WN OF SOUTHISflI�THl AMOI1TiT OE B THE TOWN OF SOUTH WINDSOR FOR AN EXPENSE INS CONNECTION WITH THIS PERMIT AND THAFPLICANT ISUF R BY THE TOWN FOR ItIgINTENQANICEDpR R�TO pAIR WORK REIMBURSE FOR PERMITS AS OUTLINED IN THE TOWN OROiITH WIIVDSR S STRI ET CUT PERIvfIT MANUAL. AMILIAI�WI_"TH AI�iI WI.LI ABIDE BY THE RULES AND REGULATIONS ------------ ISSUED BY =- - - DATEP' C TED ,ter 7/30/20124:11PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** INSPECTED BY TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: la 0013 CONTRACTOR: /J LOCATION:_ /-7 9 -f 04 Mb I t l/ TYPE OF WORK: I �� ��1�'1'2� Ci9 DATE INSP NEEDED: DATE INSP: i z �o I• INSPECTED BY: �p WORK IN PROGRESS:_ (: / rV LOCI, (.Q f7� �l o'�°Q (.�C-:.ld �"�� � /G 2+�r► !t-+�c.J �v3dL' SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION Y APPLICATION FOR STREET EXCAVATION PERMIT Appl. No. TOWN OF SOUTH WINDSOR Permit No, PUBLIC WORKS DEPARTMENT 1540 SULLIVAN AVENUE Date: 7 SOUTH WINDSOR, CT 06074 FEE % 25.00 Name Firm "/S -V,4i Phone No. S`zS�S dU� 3eS� Addresss of Firm Zip Code ®� �1I Location of proposed work Z71 ,11k2l1 ,� , ii Iu i e Describe fully nature of permit requested_ J&,21- .lnr, c�.hln cAT�I Starting date 1„ 3 1, 20 t Approx. time for completion_ I j Call Before You Dig No.�Ma -saa 1�155 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 furnish This section to be filled out by two copies of separate drawing L Indicate North Town of South Windsor ej No.cuts 0 Est. Patch Size(s) sf Est. Pvt.Thickness in. Est. Patch Unit Price$ /sf Est. Patch Cost$ Est. Curb Replacement ft Est. Curb Unit Price$ /ft Est.Curb Cost$ Est.Traffic Unit Cost$ /hr Est.Traffic Control$ Amt.of Deposit$ Total Due$ ( ) Cash ( ) Check# Applicant is responsible for contacting the Police Dept. and C.B.Y.D. Paid By 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 AS OU IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: Date: 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 159 1 I'� 3cDO 1'61 ---- `o 150 N !00 ,F co 171 N i b �Q/b i j i E i Lo N i N N r, d 179 192 178i NT�b �, o r -.R2 BAD CA. BLE 48Vb- 6 184 ------------ D5631182 �� \� SWD5631 \ 1 \ FMLIG7J-A14 NT 5 D5602 f \ \ 21/27 54/37 17 6 \ 1,10- 193 \ 1066' 20.79 � � � •�, 13/2 2/8 181 loo' RG6 \ 1 ''• R2 I CO N 170 ,fib �G 167