HomeMy WebLinkAboutStreet Cut Permits 537 Graham Road (2) 1200035 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 04/02/12 ,
GIS ID: 37500537 FEE: 00
MUNIS APPLI_CATION# 201200324_--_ - - — ---- =- �VnTn A- Tt It.�. - -- - -- - -- --- ---- _ -- -
APPLICANT LOCATION
NAME: YANKEE GAS ADDRESS 537 GRAHAM ROAD
ADDRESS: 112 PROSPECT HILL MY j iOWIEN! -TARKKCEATHER SCOTT R&STACEY M
EAST WINDSOR,CT468 = 53RAAM RD
SJTH WINDSOR, CT 06074
PHONE 860-292-2242
WORK DESCRIPTION: INSTAIf�GAEI�VrCI
%
APPLICANT AGREES TO FURNISH THE TQWI - ?EOUTHDSQRTHE AMOI3NT O $01VD REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY:g ENSES IN UI REI `B IHE T�WIV FAR 1 ffE1INTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APt�LAI�IT IS 1£ANZAR WIII ANI)WILT ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF'SIVV ILI1`JI�'SR'STREET-CU EPERII+IT MANUAL.
ISSUED BY J DATE INSPECTED INSPECTE BY
4/2/201210:58AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: OONTRACmp.
LOCA7ION: 7`,�� hG m Qc�
.TYPE OF WORK:
:DATE INSP NEEDED: DATE INSP: 1_/7—/3
INSPECTED BY:
WORK IN
PROGRESS. /4 ! 7� S C" Inc,
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Cry lei
3.
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES [:] NO
'AS-BUILT:
INPUT:
W12007 Town of South Windsor INPSEMON REPORT 07
03/30/2012 FRI 9: 16 FAX 860 292 2202 0002/003
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
- - -- - -- 1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm ('.I _ Phone No. 5C�C7
Address of Firm �L-- �_4- . �• LT n ') Zip Code
Location of proposed wo 3 r /.i.
Describe fully nature of permit requested l n S toj \ Q k S' � c�
1
Starting date uMUC_ y t . . ) Approx.time for completion_C G
Call Before You Dig No.,'0 jl,� 13 0 7� :>`7 La Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTHyMWFIC CONTR-GLAND-•THE.T•Oal -N! CONTRACT-C,GSTS: TME-PERMANENT PAT-CH-IS••T�FPICALLY
COMPLETED WITHIN A YEAR OF-THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or fumish This seoti on to be fulled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
Est.Pvt.'Thickness in.
Est. Patch Unit Price$ /sf
n '1 c N t Est.Patch Cost$
ko Est.Curb Replacement ft
Est.Curb Unit Price$ /it
Est.Curb Cost$
r� Q �10�•c,L_ � Est,Traffic Unit Cost$ /hr
Est.Traffic Control$ -
_ Amt.of Deposit$
s Total Due$
( j Cash ( j Check#
Applicant s 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 1 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS ArUTLINED IN TH TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: C� c. \ �- Date:
Tltie: 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 10-2Z-08