HomeMy WebLinkAboutStreet Cut Permits 150 Berle Road (2) 1200097 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 06/04/12
GIS ID: 10200150
1VII1NiS_A_P_P_T_ICA_T_TLl7T_i�2nt7nncne = FEE:
EXPIRATION DATE: 06/04/13
APPLICANT LOCATION
NAME: TELE-NETWORKS -ADD RESS3_ 150�13ERLE ROAD
ADDRESS: 31 BAKEWELL COUNT flW ER FL ' IN IOBERT F&CAROLE L
CRASTON,RI 02921 ISM: V 'E ROAD
PHONE 401-461-8420
OUTLWINDSOR, CT 06074
07
WORK DESCRIPTION: REPL- 0-M- E-XISTIN "----. �Z -
APPLICANT AGREES TO FURNISH THE AWN OF`SOUTH"- SQR TI UNT pF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY fXPENSE -IN UI REll BY TITS TOWN b iv INTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS AMILIAT2 WITH ANI WILD ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TO WN OF SOi TH WII�IDSR'S"-4TREVT CUT PERNf-T MANUAL.
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ISSUED BY DATE"NSPECTED INSPECTED BY
6/4/20122:11 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMESZ .
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:1262DQ9 7 CONTRACTOR: 7�P��=��10Ck c
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: G�v` DATE: 3 "
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: S Z 2
SOUTH WINDSOR, CT 06074
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Name of Firm I��/� ��t1��-��,.��� � Phone No. ��� � �9 3� �
Address of Firm 3 ! LX,11 C4 (2 cans c�:-� _ Zip Code 09ej9
Location of proposed work IV 1 0 - /65 et-e— F-
Describe fully nature of permit requested fZ'2PGCb2Q C- T�
Starting date )QW_ is "Z412 Approx. time for completion_L
Call Before You Dig No. �20)a 210 q/5 GI Existing Water Supply: ❑ Public iVater ❑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
1� ae-4 04 No.cuts
0/T , � Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est. Patch Cost$
Est. Curb Replacement It
Est. Curb Unit Price$ /ft
Est.Curb Cost$
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
CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OU IN IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: 42 t,-?—
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
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