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HomeMy WebLinkAboutStreet Cut Permits 73 Palmer Drive (2) 1300004 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 01/16/2013 GIS ID: 68400073 FEE: 0.00 MUNIS APPLICATION# 201300045 APPLICANT ; `- LOCATION NAME: CONNECTICUT WATT COMPANY` DpRES,Sy 1- PALINIER DRIVE ADDRESS: 25 NORTH ROAD 5QR SPIANNON L& EAST WINDSOR, CT�60 8 p LAfER DRIVE PHONE 860-623-3355 �, IN DSOR,CT 06074 -1 ; WORK DESCRIPTION: REP�IR 4-2 I APPLICANT AGREES TO FURNISH THE IpWL OFSOUTH IAS HE'QM4k OFBOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANI E E�PI ES"INC IS T T(WMVOR 1tIAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THE APPLICANT IS 1`AM1 IAIf WITH-AN I-WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN ONO WINDSR's� TRE .CU4T.PER1fIT MANUAL. lie ISSUED Y DATE✓INS`P` TED INSPECTED BY 1/16/2013 2:36 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** 42 jF 10 j j00 TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: 006-9y CONTRACTOR: C IA2 LOCATION: ! L mKor D TYPE OF WORK. �� , 1 �- 1 1/JD D 6T�`t Ma r DATE INSP NEEDED: DATE INSP: INSPECTED BY: WORK IN PROGRESS: 1,, 4 K 8 SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT:__ DATE: J-1 3 S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION !!!I XAIIQ14UUD Au8 0:40. VAA oou 044 146u Aoubn ftIJMQso- Town UZI" 4cvvt1ooA APPLICATION FOR STREET EXCAVATION.PERMIT TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT TOWN HALL 4540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE$25.00 Name of Firm C T 7c2 Phone No. 0, e,)A Address of F' Location of proposed wntk Describe fully nature of permit requested Starting date Approx time for completion Call Before You Dig No.o20/SOZ©O Fp/ Traffic Services control No Showsketeh of Proposed Walk orfnmish two copes of separate•drawing Indicate North This section to be fdfed out by Town of Windsor Pavement Cut 73 No.cats EsUSize of Perm.Patch(S) Est PvL Ttucb*ft in Est.Unit Price s /2 42* Amt of Deposit$ ✓�.9GtYl�YL•,8.2 ( 3Cash( )Check# Permanent Patch No.Cuts .42[7d DL G�XGEc//t9idN SmeofP s) d1O/�/dOk S'x 22' W1 ( Final Emig Due Payee AmL Due Town . By pTxant is le for eon�cti . the PaGce De t 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 MD THAT I AM FAMILIAR WITH AND WILL ABIDE B'YTHE RULES AND REGULATIONS FOR PERMITS INED IN N OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL � Date: I Trtie• Driveesu ensetk: PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES CONNECTICUT WATER COMPANY EARLY WARNING AND EMERGENCY RESPONSE NOTIFICATION To be used for early warning notification,to report an interruption of service or other emergency. Eric Thornburg,Terry O'Neill,Maureen_Westbrook,Craig Patla,Kevin Walsh,Art O'Neill,Dan Meaney,John King Paul Andrews,Pat Corbett,David Hines,Paul Lowry,Gerry McDermott,Pete Pezanko,Jeff Racicot,Reed Reynolds, Bob Ross,Don Schumacher,Matt Stosse,Bob Wittenzellner Cindy Gaudino(spills only),Tom Gaidish,Steve Melanson,Dave Radka,Pete Ranslow Central CS, Cathy Bokus,Kelly Brengi,Terri Carson,Emily Estabrook,Laurie Felleman,Jayne Hebert,Liz Johnson, Gennv Jones, Jo Lingua,Barb Neilsen,Jan Perry,Patty Wahl,Cheryl Waterbury Completed by:P.Lowry Reverse 911 Notification Used? ❑Yes X No *PURA Notification Required? ❑Yes No See PURA Notification Requirements Description—Include Region,Street.Name Date.&Time and(o Yacility Name,"Size Main,if work is repair o Number of Estimated Duration or replace;etc:Remember to,include DETAILS,e.g., Customers Affected Time Restored.' ; re air 6 cast iron main. 1/10/2013 The Northernmcild.Services department has shutdown.. 18 customers Shut dovun of gam, the water main on Palmer Drive in-South W-misor to; planning to have service' repair an V CIP main break restored by 12pm Nature of Emergency and Res onse Actions: Additional Details/Information: Estimated Lost Water(Gallons): 25,000 gallons **Must provide information to state agencies for outage impacting 50 or more customers or duration of >4 hours Outside Contacts by Region Office as necessary): Indicate name of contact and any notes: Town CEOs Town Manager Public Works Director/Town Engineer Public Safety -Local Dispatch,Police,Fire Local Health Departments DEP S ill Unit 860-424-3338 State Health Department: Email all: michael.hage@ct.gov, david.cooleyPa ct.gov, thomas.chyrakct.gov Phone-Normal Business Hours: 860-509-7333 Outside Business Hours: 860-509-8000 includes weekends and Holidays) PURA Engineering Related E-mail all: karl.baker@po.state.ct.us. george.denninggpo.state.ct.us. linda.king-corbin@12o.state.ct.us. maria.szul&o.state.ct.us Phone- Normal Business Hours:Call the following Engineering staff in sequential order until reach someone: (1)George Denning,Engineer,860.827.2876, g,eorge.denning@a,no.state.ct.us (2)Linda King-Corbin,Engineer, 860.827.2817,iinda.king-corbin&o.state.ct.us (3)Maria Szul,Engineer,860.827.2815,maria.szul a@po.state.ct.us (4)Karl Baker,Interim Engineering Supervisor-860.827.2661—karl.baker&o.state.ct.us Outside Business Hours: Karl Baker,Interim Engineering Supervisor—860.827.2661 PURA Consumer Related Matters: Maureen McCaffery,Rate Specialist,860.827.2644, maureen.mccaffery(a)po.state.ct.us Alan Bouchard,Associate Rate Specialist,860.827.2885, alan.bouchard@po.state.ct.us Outside Contacts or Follow Up from Clinton(as necessary): ❑ DPH ❑ Local Health ❑ Direct Customer Notice ❑DEP ❑ PURA ❑ School Superintendent ❑ Central Customer Service ❑ OCC ❑ Media ❑ PSL Customers