HomeMy WebLinkAboutStreet Cut Permits 99 Clinton Drive (2) 1100147 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/27/11
GIS ID:21300099 FEE:
25.00
MUNIS APPLICATION# 201101126 L3tDTD A rrTrNaT
APPLICANT , = ;,, ; LOCATION
NAME: EASTERN WATERPRQQFING ADDRESS:- 99 C INTON DRIVE
ADDRESS: P O BOX 504 CER NOQNAII MARY H
SOUTH WINDSOR,CT 0&74 99 CLIN ON DRIVE
At
OUIINDSOR,CT 06074
PHONE 860-875-6646lo-
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i
WORK DESCRIPTION: 4" GRAV Ll i Y I1 T FR ICI IG IT RI AR CORNER T 14'RCP PIPE 60'
TO RIB
APPLICANT AGREES TO FURNISH THE TWI�, PdUTIH= I3�IDSR PH1 AMQNT QF-- QND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY E)(PTfNSES W CJRREI)$ THE AAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANOI FAMILIAR VTIT AID WIC L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN
nOI{S iRb
6dA SR'S &I�I
BTI�E�T CIIT-:PEIT MANUAL.
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ISSUED BY ATE INS'P TED INSPECTED BY
9/27/201111:44AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT'NO.: 'C 00/ y7 CONTRACTOR:
LOCATION: - 1 4 I`n n b r I W�
.TYPE OF WORK: U° &V)l e144A&a C') "
DATE INSP NEEDED: DATE INSP: 15
INSPECTED BY:
WORK IN
PROGRESS: n ,-gym.- �s li � 't" Pic- Fear,
i c P o w m I kw� T010 eA P.ree 9 b' kQ�
Pon , e2� �lPch Il � � 1✓t/°F
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
'AS-BUILT:
INPUT: 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:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm eRAJ P_ PPME' -P Phone No. - DC6 J _O(AH
Address of firm_ 4 -1._ M KAA_LL_(q:T ��/ --_ Zip Code C_
Location of proposed work_ r-
DescriW fully nature of rmitrequested 411 �'�621AV rf�- 1-A-P __ 6'OYY1
Starting date SO 3 1 I Approx.time for completion v4 ))
Cali Before You Dig-No.Dbl I DO 1 a% Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE:PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS'RESPONSIBLE FOR THE FULL FINAL COST-OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
-LENGTH,TRAFFIC CONTROL AND-THE TOWNS CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish `a This section to be filled out by
two copies of separate drawing l Indicate North Town of South Windsor
j No.cuts
.Patch Sizes. Est a ( sf)
0
+° s® , Est.Pvt.Thickness in.
All Est.Patch Unit Price
Est.Patch-Cost$
Est.Curb Replacement ft
G v I I Est.Curb Unit Price$ /It
�PG
Cw b Est.Curb Cost$
1� Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
S) Amt.of.Deposit$
C`yn1-0ri
Total Due$
( )Cash ( )Check#
Applicant is responsible forcontacting Paid By
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 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMI AS OUTLINE IN THE TOWN OF SOUTH WINDSOR'S STREET C T PER 111MANUAL.
Sig Dater
Title: 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 10-22-08
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