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HomeMy WebLinkAboutStreet Cut Permits 11 Old Parish Drive (2) 1200228 TOWN OF SOUTH WINDSOR PERMIT NUMBER C T STREET CUT PERMIT DATE: 11/07/12 -_ GIS ID: 66600011 MUNIS_APPLLCA_T_ION ii 2nt2nisn _FEF. EXPIRATION DATE: 11/07/13 APPLICANT , '  LOCATION NAME: TELE-NETWORKS � ADbTtE�S: 11 OLD.PARISH DRIVE ADDRESS: 31 BAKEWELL COULZT CWNEROLABESE PATRICK J&ZANE A CRASTON,RI 02921 = - % IL COLD PARISH DRIVE PHONE 401-461-8420 SOUTH Is WINDSOR,CT 06074 WORK DESCRIPTION: INSALLREISL �EV � APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH���QJtT�3trAMO1:J3�IT OFBOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANY E�PEItFSE�INGi3RRI�I�BY�.1JE.I.O�I�J FOIE I�fAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND TI��APPLICANT TS�A1E�i,IAR UC�ITH AND�VILI,ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OFF©LZTH WII�IDSTREE `CUT FRMIT MANUAL. cl ISSUED BY DATE 4SP-ECTED INSPECTED BY 1 1/7/2012 1 1:26AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: ZQZ�12 CONTRACTOR: t'e' gtik LLI)rkS LOCATION:_) `"� ,� car 1 S r TYPE OF WORK: n L`n- 1- DATE INSP NEEDED: DATE INSP: ;2 - y INSPECTED BY: 6b WORK IN PROGRESS: 0- )q j SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: - _ 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: 1116 9 SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm �� �-.V��f�1Tt>^ S Phone No. 2re-I S, 0";L Address of Firm 9 79 rKrjc c P,-5 �c�el Zip Code 0L Si 9 1 Location of proposed work //-3 9 O 16 pmr,'sk C->- Describe fully nature of permit requested ems - II IIZ42hax r"4 TU Starting date 'g o 1 Approx. time for completion I oc Call Before You Dig No. 90 i�L 4/5-0 99(4`►- Existing Water Supply: ❑ Public 4ter ❑ Well Existing Sewage Service: ❑ Public Sewer ❑ Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A. PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch of proposed work or furnish This section to be filled out by two copies of separate drawing Indicate North Town of South Windsor 'See No.cuts 0 Est. Patch Size(s) sf Est. Pvt.Thickness in. Est. Patch Unit Price$ /sf Est.Patch Cost$ Est. Curb Replacement ft 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 Npq IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: Date: j bolq 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 i 1 Ir 09 a .86 CL J R2 80' N/A _ c) RG6 C i cL 4.3 32 J cy)ol 70 CIO r CD O it — .500P3 ` R� N; . ' BAD HARDLINES .500P3 .500P3__ f .50OP 1 ------- ' 6 1 Or ----------------------- _- . � � i JA0242 --i-_,--- 1 G7J-A 14 ! A0202 \O- r 54/37 �I o j 23/20 ° r N/A 22.53 8/12 r j T t 1 r" 1 i p N r t f i 1 r