HomeMy WebLinkAboutStreet Cut Permits 16 Allen Drive (2) 1100124 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/22/11
GIS ID: 02100016 - = FEE: 25.00
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APPLICANT LOCATION
NAME: AIROLDI'S INC. 'ADDRESS 16 ALLEN DRIVE
ADDRESS: P O BOX 71 C}W3ER 'IAYLORDIANA S
SOUTH WINDSOR,G74 `- 16 ALLEN DRIVE
?UTVVINDSOR,CT 06074
PHONE ,,, ;
WORK DESCRIPTION: DRIVEWAY
et
THE DRAIN LAYER ASSIGNED TO THIS PERM HAS---,,A CAI ID LIENS ISSUED BY T3ET ATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH- I HE ATTA HEM`C01�1F311 IONS"ALI.WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARbS,AI l OSHA REQY7IIZEMENTS,ANII THE`ATTACHED CONDITIONS.
ISSUED BY DAT INSPECTED INSPECTED BY
8/22/2011 2:50 PM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: P I �� a`� CONTRACTOR: A ;r 0 �� L N C..
LOCATION: I(v A 1�);
TYPE OF WORK: h s- j re
DATE INSP NEEDED: DATE INSP: Ia t
INSPECTED BY: (ab
WORK IN (-
PROGRESS: o � �
AS-BUILT:
INPUT: t: �`�` DATE:
W/2007 Town of South Windsor INPSEMON 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 $25.00
Name of Firm �"���� S\ N�' Phone No. ag� '38�Al
Address of Firm Q�a- Q� `� �o �',��,so� Zip Code Oboes
Location of proposed work
Describe fully nature of permit requested
Starting date 73 Approx. time for completion
Call Before You Dig No. '����33d a5�� Existing Water Supply: El Public Water ❑ Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est. Patch Size(s) sf
Est. Pvt. Thickness in.
Est. Patch Unit Price$ /sf
;g Est. Patch Cost$
4/
33' 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 OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: \ � �� _��.��..A� Date:
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