HomeMy WebLinkAboutStreet Cut Permits 3 Carey Lane (2) 1200024 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 03/22/12
GIS ID: 16800003 FEE:
MUNIS APPLICATION# 201200289 25.00
03/22/13
APPLICANT „ LOCATION
NAME: TELE-NETWORKS A�DRESST 3 2 CAREY LANE
ADDRESS: 31 BAKEWELL COURT _ DER WONG GHUC TRAN&DOMINIC CHO YAN
CRASTON,RI 02921 3 CAYLANE
SOOMWINDSOR, CT 06074
PHONE 401-461-8420 =
WORK DESCRIPTION: INSTALAAkP-- AG C V
APPLICANT AGREES TO FURNISH THE%WA
OIpUTHNI�S�)RIE AMpULT pE,BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AA, PI�NSES Mm6fURREDAnTH TQWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS R)Vml)m`WISH AND WI 1 ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OFsOLT H WIIDR'S STRIFUHT PERMIT MANUAL.
ISSUED BY DAM ED INSPECTED BY
3/22/201210:44AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
AF
AN
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: a (Wo 001YtRACi'OR: f
LOCATION:
.TYPE OF WORK: `T'�
so
DATE INSP NEEDED; DATE INSP:
INSPECTED BY: RD
WORK IN
PROGRESS: _ S
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: U� DATE:
4
W12007 Town of South Windsor INPSEMON REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT ld6 tY
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT Z
1540 SULLIVAN AVENUE Date:3
SOUTH WINDSOR, CT 06074
FEE $25.00 C
Name of Firm �{���' e�W COY'\� S Phone No.L_ s S 2,3 2
Address of Firm 12..E Zip Code QZ9 0 3
Location of proposed work
Describe fully nature of permit requested IV\ �' �� re _ (ace- Cat
Starting date 3 ('a Approx.time for completion
Call Before You Dig No.aoo C - 1 a ?j� Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
s p4:1 �Vt-� a c1 ,e d
No.cuts
0
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /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 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 MANUAL.
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
5 B 1403 5 B 1403 P(3 ra 190 a�7
32/25 54/37 32/25 54/37 sao-k,
17/17 28/27 17/17 28/27 Li<�dSr3r
401' 9.66 415' 9.43
l n!�
I
89.2 T 89.2 T
18
G� o_
60,
R R2 \ 612�
—� 70 0- 156
3dB/RC 9/' i
eed to TDR the cable from hte 17-2 to the 11-2 low levels
10`' _ M
.S p
o
ry
N 2
11
CN o
C3)
f
cM 0
` N L\ ►�
1
8