HomeMy WebLinkAboutStreet Cut Permits 125 South Satellite R (2) 1200149 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/20/12
GIS ID: 84000125 - FEE:M 25.00
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EXPIRATION DATE: 08/20/13
APPLICANT; LOCATION
NAME: ADVANCED CONSTRI7COI ADDRESS 125'SOUGH SATELLITE ROAD
ADDRESS: 5 CHESTNUT HILL ROAD?' 1 -77IR GLOBAL TURBINE COMPONENT
STAFFORD, CT 0607 = Z2 SLSUTI SATELLITE RD
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77I WINDSOR, CT 06074
PHONE 860-519-8442 ,
WORK DESCRIPTION: INSTAL ,7?
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APPLICANT AGREES TO FURNISH THE TOWIQFOTJTI V3I3tR IIE>gNIpUT OFOID REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY=E}�ENSE IN'te-1 Y IHE IOWN FflR IvtAINTENANCE OR REPAIR WORK IN
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CONNECTION WITH THIS PERMIT AND THE APFLIANT LS F�AMIIyIAR�UITAN133 WILD ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SUUTIT WINIISR- TRT CUTPLRMTT MANUAL.
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ISSUED BY E INSPECTED INSPECTED BY
8/20/2012 11:06 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: f i�Do&/ CONTRACTOR: /Q� �
LOCATION: /II e, �f
TYPE OF WORK:_ sm l j
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: to
WORK IN
PROGRESS: f- i
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: �� DATE: �' 1
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR, CT 06074
Name of Firm A0 0f� (-P—0 C 0Y):i. O)GO f n(� Phone No.sub- SA� 2 W Z
Address of Firm cS Ci*S1nQT SOU, 1_ICACk 6C Zip Code (O
Location of proposed work
Describe fully nature of permit requested V STIR
Starting date & % Approx. time for completion , Z`7
Call Before You Dig No. 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 TOWN'S 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 This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No. cuts
�Ja�r�e� fi ,�
_ _�(� ,� Est. Patch Size(s) sf
Est. Pvt.Thickness in.
` Est.-Patch Unit Price
Est. Patch Cost$
T Est. Curb Replacement ft
. v
L Est. Curb Unit Price$ /ft
Est.Curb Cost$
Ln
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
( ) Cash ( ) Check#
Applicant is 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
CONNECTI WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMIT AS O TLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: V f
Title: Driver's License#: ? )
11-71
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