HomeMy WebLinkAboutStreet Cut Permits 339 Chapel Road (2) 1200188 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 10/02/12 ,
GIS ID: 18000339
MUNIS APPLICATION# 201201285 .00
EXPIRATION DATE:
APPLICANT
.13
LOCATION
NAME: METROPOLITAN DISTRICT AI3DRES :' 33 ,EI&PEL ROAD
ADDRESS: 125 MAXIM ROAD ER` —A-ATHER FAMILY LIVING TRUST
HARTFORD,CT 061 I4371I*1 ST
/ SQUTII INDSOR, CT 06074
PHONE
WORK DESCRIPTION: REPAIR WAT
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH p BOND OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY"PETII;E,S I1�GFIRRED TOWN FOR I�tAINTENANCE OR REPAIR WORK IN
HE
CONNECTION WITH THIS PERMIT AND T AL'PLI6A - IS FA +I I TAR UJI PTI AND WII L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OFOUT1 U .1NDRSTET CUT IER1efI I MANUAL.
ISSUED BY DATE INPECED INSPECTED BY
10/2/2012 10:51 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR:
LOCATION:_ _33c� �— p,r4
TYPE OF WORK:_
DATE INSP NEEDED: DATE INSP: I �� '13
INSPECTED BY:
WORK IN
PROGRESS: �iyje—"ll
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: ._ DATE:_ )_7 I e
S/FORMS[TOWN OF SOUTH WINDSOR INSPECTION
MD-oas, Rev2/12 THE METROPOLITAN DISTRICT- PAVEMENT CUT DATE:
ADDRESS -3 G�'l BILL JOB ❑ YES J,���,� o WO#
N 11 v
LOSEST STREET_ Tb A N �V U/• TOWN _ W n S 0-rL-- STATE HIGHWAY ❑YES'
DRAW SKETCH SHOWING LOCATION AND SIZE OF CUTS AND1 CUT MADE IN
L CROSS SECTION OF PAVEMENT
-�t- Cl STREET ❑BITUM. " ❑GONG. ❑ PREMI A
\ ` ❑SIDEWALK ElBITUM. " ❑GONG. ❑FLAG "
❑CURB ❑BITUM. ❑CONC. ❑STONE '
El DRIVEWAY ❑BITUM- D GONG. "
,Q<RASS LOAM&SEED NEEDED ❑YES 2�0 ^-
REASON FOR CUT: n rn
' O
r
DEPTH OF EXCAVATION:
NUM13ER OF CUTS:
i Iz
E 0L DATE OF FIRST CUT:
IS JOB COMPLETED: �S ONO
FOREMAN:
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`� � C vet•� �'
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REPLACEMENT PAVEMENT ;ON C CT N Z
CID BITUMINOUS ❑ CONCRETE ❑ PREMIX D
o DATE COMPLETED:
ACCOUNT NUMBER:
i
CALCULAnJNS
OF CUT ITEM; ITEM# ITEM# TEM# N
'Y
CV I
O
C-4
Chi
Cal
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PAVING INSPECTOFI CONT14ACTQR
PRESS AL, 3 CONIES (ORICENAL) (YELWW)