HomeMy WebLinkAboutStreet Cut Permits 411 Abbe Road (2) 1200078 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 05/21/12
GIS ID: 00600411
MUNIS APPLICATION# 201200624 FEE: 00
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APPLICANT = LOCATION
NAME: YANKEE GAS y�-_DRE k kB$E ROAD
ADDRESS: 112 PROSPECT HILLRD
EI GRQ-XF(5D CYNTHIA D
EAST WINDSOR,CT 06Q,$S 11 I BBB ROAD
PHONE 860-292-2242
iJT`I WINDSOR,CT 06074
WORK DESCRIPTION: REPI ACF TESS �1 If7N ONrAS� 1PH-10 TO SIDE OF ROAD
APPLICANT AGREES TO FURNISH THE Tt?WFI flFN$0 TH.WI1 tDS R = OIJNI fj BQND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANC-�E-P�1S-S 3Ik1 URR D BY�1 HE T{ I flR M INTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE t�PPLfCANT.S A,T IAK WITH AItII3 WI I ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S( IT WiNbSR3TRL�T CU'lPLRMIT MANUAL.
116 y
r-r { 3; �
ISSUED BY DATE�NSPECTED
INSPECTED BY
5/21/20129:26AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 12 00078 CONTRACTOR:- YV -L G
LOCATION:- 4tI/
TYPE OF WORK:_ fi a K G4-���
DATE INSP NEEDED: DATE INSP: i /7--/3
INSPECTED BY:_6-t�> _
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: y
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR STREET EXCAVATION PERMIT
AWL No. TOWN OF SOUTH WINDSOR PerrWd'No.
PUBLIC WORKS DEPARTMENT'1540 SULLIVAN AVENUE Dater �60Id
SOUTH WINDSOR,CT OW74
FEE $25.00
Name of Firm Ci +%t 2 G-APhone No. 3 ' ,S a
Address of Fi - r a _ °I U ° e./- Zo Code 0 A 0 DSO'
Location of proposed work b_b
Describe fully nature of permit requested I .5
Ove. +O e_ (?'P 1^0q�
Starting date a I Approx.time for-complete oa0l,
Call Before You Dig No. o 1 g o 3 Y 2 6 Existing Water Supply: ❑Public Walter ❑Welt
Existing Sewage Service: ❑Public Sewer - ❑Septic
PLEASE NOTE; THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC-CONTROL AND THE TOWNS CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
-Shaw sketch of proposed work or furnish This section to be IBM out by
two copies
separate drawing n�► Indicate-North Lgwn Of Scb or a m%jSjs
J e_ "f`.+a �� ! " ��2 No.cuts
Est.Patch Sizes) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patcle Cost
Est.Curb Replacement ft
Est.Curb Urrit Price-$. /ft
Est.Curb Cost-$,
EsL Traffic Unit Cost$ ttu
Est.Traffic Control;
AmL of Deposit$
Total Due;
( )Cash ( )Check#
Applicant is responsUe for contacting Paid By
the Police DepL 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 AAA FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS S 7CV�_7
STREET CUT PERMIT MANUAL..Signed: _, Date: 1 r�1 a 4 f
Title: L st 6 o la 2/— Driver`s License#: A 3 A Qr Id')01
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 dOBSiTE AT ALL TIMES j'