HomeMy WebLinkAboutStreet Cut Permits 172 Fairview Drive 1200023 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 03/22/12
GIS ID: 31500172 - FEE: 25.00
IVIUIN13 HrrL,iUA l lk-iN ff ZV lZUu/-aa = EXPIRATION DATE:jo
03/22/13
APPLICANT - LOCATION
NAME: TELE-NETWORKS ,9DDRES� 172 AIkVIEW DRIVE
ADDRESS: 31 BAKEWELL COUNT �E %FLWOR
TH BRUCE P&
CRASTON,RI 02921 X ip-
IR---VIEW DRIVE
IR OUlL WINDSOR, CT 06074
PHONE 401-461-8420 - ,
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WORK DESCRIPTION: INSTAUfREPA&E-WA
APPLICANT AGREES TO FURNISH THE*W—JIB OUTII ItID I 1 E AMOUNT OE B(3ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY-EXPtAldS AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLE VANT IS I t Mffl IAIr W THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF nI7UTIINI�W51�5 STRE t f- PERMIv IT MANUAL.
ISSUED BY j6ATVINSPMTED INSPECTED BY
3/22/201210:40AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT No.. Obi 3 CONTRACTOR: ���` n� -
LOCATION: 1
TYPE OF WORK: :E:vi5 11 Iwo lrc'C C�4 `7'�
-DATE INSP NEEDED; DATE INSP;
INSPECTED
WORK IN
PROGRESS:_
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
'AS—BUILT:
INPUT: DATE: �—
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT IaC1CO-�'3
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:J" a-
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm tE'' Q ' �C'�UJOY'�� S Phone NoJ sgro- 2,30 Z
Address of Firm k�rOQ WCk- (O\J V\ ' Q�L Zip Code OZ9 v 7?
Location of proposed work ' FWVAA140w oc,
Describe fully nature of permit requested 1VX 3" w ce (ace- C(k-t v
Starting date 3-a -)A I --)- Approx.time for completion
Call Before You Dig No-rm5- k5�Z3 d- Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
s ie4a, ��t-� a c\ne d
No.cuts
0
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price
Est. Patch Cost$
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 MANUAL.
Si Dater-p - i`-
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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' Sis in CPB bar he r L the ingress goes away.
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I Push the input CPB bar here and the ingress stays. Swapped out tap housing and there was no change. Tap housing was burnt.
J � CO Replace this 300'span of cable.o
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