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HomeMy WebLinkAboutStreet Cut Permits 411 Quarry Brook Driv (2) 1200146 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 08/20/12 GIS ID: 74100411 = FEE: 25.00 MUNIS APPLICATION# 201201065 - EXPIRATION DATE: 08/20/13 APPLICANT, = = LOCATION NAME: TELE-NETWORKS ADDRESS- 4I1 QUARRY BROOK DRIVE ADDRESS: 31 BAKEWELL COURfi - I lllm { R M 1MAKkANWARJIT S&DHEERAJ CRASTON,RI 02921 = 411 (AIRY BROOK DR AW SLT WINDSOR,CT 06074 PHONE 401-461-8420q 3 - is WORK DESCRIPTION: REPLXGE- kI-mIitCA'`� APPLICANT AGREES TO FURNISH THE TQWb 9F OUTH �SOI} I E AMOIWOt BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANY== }i'FSES II*ICfRRI1 BY THE TOWN F�3I I�IAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THE -PPLI-ANTS FAS IT14Al-S1 WILE ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF 06fi -1.0SR? TREEt UT PI RIM6 MANUAL. 014 dou - ISSUED BY DATt INSPECTED INSPECTED BY 8/20/201210:40AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: 00r CONTRACTOR: g LOCATION: TYPE OF WORK: r DATE INSP NEEDED: DATE INSP: /S ' 2 INSPECTED BY: P--) WORK IN PROGRESS:_ `mod 9L„� SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: -/ 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: / / SOUTH WINDSOR, CT 06074 -- - - - -- - -FEE $25.00 -- - - -- Name of Firm �'A @� r�5 Phone No. — Sit 5 Address of Firm 31 G-Aeuet j C- C-ra^s-fern Ll:_ Zip Code © la 1 Location of proposed work 1-///—y ( y4(T,r &eea Or- Describe fully nature of permit requested tZtM 4e.I44 et sh 7 C,Q'I"�,t Starting date z-o 12 Approx.time for completion l QE,� Call Before You Dig No. U Existing Water Supply: ❑ Public Water ❑ Well Existing Sewage Service: ❑ Public Sewer ❑ Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch of proposed work or furnish This section to be filled out by two copies of separate drawing Indicate North Town of South Windsor ae / Qd No.cuts 1� Est. Patch Size(s) sf 0 Est. Pvt.Thickness in. Est. Patch Unit Price$ lsf 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$ O 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 O TLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: Date:*/`" 20( 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 - - 5 SWB 1305 QO 1 B 6 ' ', g 2p1 5U 4`+ RGb � \ . \fib c00 a 1� BAD CABLE \ 441'', < \ o` w 433 5o R `. .500P3_ 1: -- 50 43 SWB1306 " FMLIG7J-A14 N V/L 6 B1301 �_ 1 21/25 54/37 � 17/17 28/26 812 19.1 CL BAD CABLES 11/2 2/6 N I 80.5 T / tC I V/L 6O V1 N Y c� LO ., 63 - - - 60' V/L 1 IF r .500P3co