HomeMy WebLinkAboutStreet Cut Permits 111 Austin Circle (2) 1200022 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 03/22/12
GIS ID: 05900111 FEE: 25.00
MUNIS APPLICATION# 201200287 - - EXPIRATION DATE: 03/22/13
APPLICANNTPF
t LOCATION
NAME: TELE-NETWORKS A��DRESS 111 AUSTIN CIRCLE
ADDRESS: 31 BAKEWELL COUNT %DER. T INKSI INDA
CRASTON,RI 02921 f ' }N CIR
�' S9IJTH VINDSOR,CT 06074
PHONE 401-461-8420 _
WORK DESCRIPTION: INSTALL REPAL a-E CV- "
APPLICANT AGREES TO FURNISH THE T ?WN9F�OUTH Nlf# Y�E AMOUIIT QF B(}ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN�,EXP� S I ICIJL�ED I3 THI 3O1 NFOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE AP#LrANT IS FAIVII I YA1 WLTA>1I?WIL'7 ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED INj THE TOWN ON ET C UXi PERMIT MANUAL.
ISSUED BY DAIMNS' PJCfiED INSPECTED BY
3/22/201210:38AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: - 0010c - CONTRACTOR: CEP/e-_ ��Or.�S
LOCATION: '
�l � u ���, � c i ale
.TYPE OF WORK:_11^ y_)
:DATE INSP NEEDED: DATE INSP: f a 1.10 f
INSPECTED BY:_ �
WORK IN
PROGRESS:
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑ NO
'AS-BUILT.-
INPUT., DATE:
-L4441,:=--
W12007 Town of South Windsor INPSEMON REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR, CT 06074
i FEE 25.0
Name of Firm k-\-e - w e4-uxr 1- S Phone No.I" �4 `� Z30 2
Address of Firm 1 ��r�Q W � (OVL C '� �2-L Zip Code OZ9 0 3
Location of proposed work I A(J � 1 n
Describe fully nature of permit requested 11n 3-ickk ce Face Cat -j
Starting date Approx. time for completion UI
Call Before You Dig No—)-6kQ- Qr6 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
No.cuts
Est. Patch Size(s) 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$ /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 A OUTLINED THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT iMANUAL.
Si Date:
itle: 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
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