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HomeMy WebLinkAboutStreet Cut Permits 15 Natsisky Farm Road (2) 1200126 PERMIT NUMBER TOWN OF SOUTH W I N D S O R, CT DATE: 07/23/12 STREET CUT PERMIT �= - � -: GIS ID: 62300015 MUNIS APPLICATION# 20120092R - " y FEE:- DPIRATION DATE: 25.00 APPLICANT = 07/23/13 NAME: TELE-NETWORKS LOC_rj�N ADDRESS: 31 BAKEWELL COUNTp�l fADDRESS= I NATISKY FARM ROAD CRASTON,RI 02921 OWNER MAGNOLI ANTHONY& PHONE I -NAfiISKY FARM RD 401-461-8420 - SOUTH VINDSOR, CT 06074 WORK DESCRIPTION: REPfiAIIVG ETTI1� I �T APPLICANT AGREES TO FURNISH THE TOWIx1 DF SOUTH THE TOWN OF SOUTH WINDSOR FOR ANY_EXVPENSI g IN- N SOR TEE gMO T OPB()ND REQUIRED AND TO REIMBURSE CONNECTION WITH THIS PERMIT AND THI APPLICANT IS IEb BY TO WN FOR 1111AINTENANCE OR REPAIR WORK IN FOR PERMITS AS OUTLINED IN THE TOWN ONO�HWINDSR S STREET CUT PERMIT MANUAL. ARII,IAIE WITH ANC MILL ABIDE BY THE RULES AND REGULATIONS ISSUED BY E� PECTED ��. 7/23/2012 9:22 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** INSPECTED BY TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT CONTRACTOR: t f Ap- ii-E'_7r7,w f k_ - LOCATION: 1.5� Al i kFa- lz - TYPE OF WORK:_ 920&-j G 6­'_. DATE INSP NEEDED: DATE INSP: INSPECTED BY: SD WORK IN PROGRESS: i)o u , H .f �/�i�c✓ SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: LLB DATE: Y S/FORMS/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: 7- SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm Phone No. SS'�5� FS;64 S` Address of Firm 31 Baket.Jc? (i C-{ rv►s n '(�-T Zip Code ©2a I Location of proposed work 1n-ter5ec--h'q i 1 1. W Describe fully nature of permit requested_ 94 Lqc,, C A -[L/ Starting date_ -;&U\,i 1 ti Z O I Z Approx.time for completion Call Before You Dig No.2d(z �z R'd 2q cl2- Existing Water Supply: ❑Public Water ❑Well Existing Sewage Service: ❑ Public Sewer ❑ Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch of proposed work or furnish This section to be filled out by two copies of separate drawing Indicate North Town of South Windsor 5 � � .C'A ea J No.cuts Est. Patch Size(s) sf 0 Est. Pvt.Thickness in. J� Est.Patch Unit Price$ /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 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 THE RULES AND REGULATIONS FOR PERMITS AS 9, I-FqED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: Date: ,�A/ Q i Zo (Z 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 22 s9. jl �0 18 R b 135 60, R 6 Rl s, pQpV R2 S hp A Qrb , cb�L O ` ho \ •S f Qom' �'`_�=� o. Q 4 h00 RG6 Losing 3db on Ch>133. i �\ W 6 cl22 OQ SWD0610 h0 ;pub R j FMBIGPJ D0602 25/30 54/37 7/17 24/21 15 2/8 i ' 04/3 14/11 OQ ' 88.6 T °' CF1 16 Replace 72' of .500 cable. Loy 108 1400 uVm leak i p ho