HomeMy WebLinkAboutStreet Cut Permits 442 Foster Street (2) 1200085 TOWN OF SOUTH
PERMIT NUMBER H WINDSOR, C T
STREET CUT PERMIT
DATE: 05/30/12 /
GIS ID:33600442 ;
MUNIS APPLICATION# 20 12nnr,'1- _. _
EXPIRATION DATE: 05/30/13
APPLICANT� .,
NAME: AIROLDI'S INC. LOCATION
ADDRESS: P O BOX 71 AI�DRESF; 4FOTER STREET
SOUTH WINDSOR, CT 9Q4 E�3TER GAGNEl ROBERT D&RITA G
4 OS 'ER STREET
PHONE = ?TJTH VINDSOR, CT 06074
WORK DESCRIPTION: DRINEA"Y
APPLICANT AGREES TO FURNISH THE I Q WOFOUTH �SQR THEMOIt11Tff
O BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN 'E3PEIVBES.INRREI�BTHRTOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TH AP I lCANT IS F,�IVII IAR WITH AI*II�V�I I ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SLI IVi�IIDSR S STREE SCUT_PERMIT MANUAL.
C .,
ISSUED BY DAI'E INSPECTED
5/30/2012 11:43 AM *** INSPECTED BY
PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
`" -
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1 a O®085 CONTRACTOR: /a i srD 1 of 1 S
LOCATION:
TYPE OF WORK: �l VIP i.l
DATE INSP NEEDED: DATE INSP: f- 1-7 l3
INSPECTED BY: (>,C>
WORK IN
PROGRESS: S Kg"
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: ��-
-- - -_ - - --- - SCIIITIa_wimnsr)R -CT-nrn7d - - - - -- - - - - - - -
FEE $25.00
Name of Firm ���c ao\d��� Phone No. g 6a •`a8�►- 3�
Address of Firm y `11 �Joy���J.,. 's Ck Zip Code 06onLl-
Location of proposed work
Describe fully nature of permit requested .-o�� Q.�. ���\p��Q�' ���•t
S!aning date . � Approx. time for completion
Sall Before You Dig No.' Existing Water Supply: ❑ Public Water El Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS, THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Snow sketch of proposed work or furnish This section to be filled out by
!wo copies of separate drawing Indicate North Town of South Windsor
I
No. cuts
I .
I
Est. Patch Size(s) sl
1. Est. Pvt. Thickness in.
Est. Patch Unit Price$ :sf j
Est. Patch Cost $
Est. Curb Replacement it
Est. Curb Unit Price$ :ft
Est. Curb Cost$
I
Est. Traffic Unit Cost$ !hr
Est.Traffic Control $
Amt. of Deposit$
I
Total Due$
( )Cash ( ) Check#
i
Aaplicant is responsible for contacting Paid By
!ne 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
PERMITS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: 1�'�>�\�
T,tie �z�e.�\ ��� . 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
::ree� Excavation Permit 08 REV 10.22.08