HomeMy WebLinkAboutStreet Cut Permits 16 Allen Drive 1200046 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 04/16/12
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GIS ID: 02100016 FEE: 25.00
MUNIS APPLICATION# 201200417 FpLlzn rin�.r_ne ram. �.,
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APPLICANT LOCATION
NAME: AIROLDI'S INC. DQRE$� 16 AZL11N DRIVE
ADDRESS: P O BOX 71 = WR TYI ORDIANA S
SOUTH WINDSOR, CT 07.4 16 ALLE 1 DRIVE
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ViINDSOR,CT 06074
PHONE
WORK DESCRIPTION: DRIAEVM
APPLICANT AGREES TO FURNISH THE TOWI jnoF OUTL iY 1i ICE AMOUI II I3Ii hC&D REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY-E POR 1VIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPL'AN I I FAIVI IWWITff-AND WII ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF 61- T WII*I�SR 3- TI T G PERN�IT MANUAL.
ISSUED BY DATE INPCTED INSPECTED BY
4/16/20122:38PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
_ • PERMIT NO.: �v/a
COWTRACtOR: A i �p
LOCATION: I6 />eti ��
.TYPE OF WORK: ��G
.GATE INSP NEEDED: DATE INSP: Ll �3
INSPEaw 6Y: rib.
WORK IN
PROGRESS:
HED, FILLED WITNESSED El YES NO
'AS-BUILT:
7 •13
DATE �
W12007 Town of South Windsor INPSEC nON 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
FEE $25.00
Name of Firm S c_ Phone No.
Address of Firm_ C7 bd'a �ode O G<")14-
Location of proposed work
Describe fully nature of permit requested
S!aning date \� \ �- Approx. time for completion
Cal! Before You Dig No. Existing Water Supply: ❑ Public Water ❑ Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE, THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Snow sketch of proposed work or furnish This section to be filled out by
!Wo copies of separate drawing Indicate North Town of South Windsor
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No. cuts
Est. Patch Size(s) SI
Est. Pvt. Thickness in.
Est. Patch Unit Price$ sf
Est. Patch Cost$
Est. Curb Replacement It I
Est. Curb Unit Price $ Jt
Est. Curb Cost$
Est. Traffic Unit Cost$ hr
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Est,Traffic Control $
Amt. of Deposit$
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Total Due$
) Cash Check
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Applicant is responsible for contacting Paid By
me Police Dept.and C.B.Y.D.
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
PERMIT OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
slaned: Date: �N\
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
S:reec Excavation Permit 08 REV 10-22-08
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33
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16'
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date. if you cancel, any property traded in, any payments made by you under the contract or sale, and any nego-