Loading...
HomeMy WebLinkAboutStreet Cut Permits 194 Hillside Drive (2) 1200185 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 09/21/12 GIS ID:43800194 FEE: 25.00 MI_W__TRAP-LTSCA-TTCY rd i IA 9- 1 13 APPLICANT LOCATION NAME: AIROLDI'S INC. AbI1S 194 HILLSIDE DRIVE ADDRESS: P O BOX 71 o ERs BROWl MICHAEL A&SANDRA K SOUTH WINDSOR, CT 06074 194I4IL SIDE DRIVE SOUTH WINDSOR,CT 06074 PHONE ,,.. WORK DESCRIPTION: DRIVEyYAY APPLICANT AGREES TO FURNISH THE OWN'OF SOUTH S�1N41SOR T IE-AMOU-IT OF BC&D REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR A X E PEN ES IN I ItItETJ$Ir'I'iI) TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THIS AI, 1-jCAW IS FAM I IAR VC IT I AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WIND$ STi1 EE ""Ci7T IsERI IIT MANUAL. 0. ISSUED BY DA' ESPEC'fiED INSPECTED BY 9/21/2012 2:47 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: CONTRACTOR:_ all' LOCATION: 19 t l TYPE OF WORK: DATE INSP NEEDED: DATE INSP: �2 7 ` -5 INSPECTED BY: WORK IN PROGRESS: 1��:n sz S SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: W\ DATE: —*)-- S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION t5'1?";t�1..7.�+� 'p "'iKt 3k• I �:��i-,? APPLICATION FOR STREET EXCAVATION PERMIT Appl. No. TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT SOUTH WINDSOR, CT 06074 \\ FEE $25.00 Name of Firm Phone No. ���\�—$0% `��� Address of Firm Zip Code ©6071 LE Location of proposed work \c-`\— Describe fully nature of permit requested 4t. Starting date Approx. time for completion wiz Call Before You Dig No. Existing Water Supply: ❑ Public Water ❑ Well Existing Sewage Service: ❑ Public Sewer ❑ Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch of proposed work or furnish jhis Sectlpn to be fllled out by two copies of separate drawing Indicate North Town of South Windsor i No, cuts Est. Patch Size(s) sl Est. Pvt. Thickness in. I Est.Patch Unit Price$ /sf - Est, Patch Cost $ > Est. Curb Replacement fl i Est. Curb Unit Price$ /ft I Est. Curb Cost$ Est. Traffic Unit Cost$ /hr Est.Traffic Control $ i Amt. of Deposit$ Total Due $ ( )Cash ( )Check# Applicant is responsible for contacting Paid By I 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 PERMIT,) D IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.' Signed: Date: Title: Gzr Z " 5 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