Loading...
HomeMy WebLinkAboutStreet Cut Permits 80 Kimberly Drive (2) 1200216 PERMIT NUMBER TOWN OF SOUTH WINDSOR, CT STREET CUT PUBLIC UTILITY DATE: 11/05/12 " GIS ID: 50300080 = 'IS APPLICATION# 201201479 - FEE: 1 PIRATION DATE: .00 APPLICANT NAME: YANKEE GAS LOCA1 jpj�T ADDRESS: 112 PROSPECT HILL RID2 - DRESS:- 80 KIMBERLY DRIVEMEMO- EAST WINDSOR, C Tomon 77:74- LFIBOB LC 80I1GIBERLY DR PHONE 860-292-2242 -- }TJTH WINDSOR,CT 06074 WORK DESCRIPTION: " INSTALL SAS V� AGREES TO FURNISH THE TIO ME- APPLICANT THE TOWN OF SOUTH WINDSOR FOR ANY xPENSE-S COI} 3 OF$AND REQUIRED AND TO REIMBURSE CONNECTION WITH THIS PERMIT AND THE --IS IAAR WLTITANI3 WIC I ABIDE BY THE RULES AND REGULATIONS ?� 1 H1 3f3WN F(QR i1+fAINTENANCE OR REPAIR WORK IN FOR PERMITS AS OUTLINED IN THE TO WN OFQi�`1'H�VII�DSR�S�TREET CST PENT MANUAL. 10 " ISSUED BY DA� 1N�PE�TED 11/5/2012 9:39 AM *** INSPECTED BY PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** ,- 2" ij TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: /a2 C Od 1� CONTRACTOR: �JCc►r1�!PP. LOCATION: ,<y, r' TYPE OF WORK:_ 1 ►n 5,_G \] of a A 'S'er V i cro DATE INSP NEEDED: DATE INSP: l f 3 INSPECTED BY: WORK IN PROGRESS: ' ear a C�.�C /►'icy 1� /1 ; �. C "A- e vn p� � SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT:_(,Vv`,,, DATE: SjFORMS/TOWN OF SOUTH WINDSOR INSPECTION 10/30/2012 TUE 6: 58 FAX 860 292 2202 ID002/002 APPLICATION FOR STREET EXCAVATION PERMIT Appl. No. TOWN OF SOUTH WINDSOR Permit No. PUBLIC_WOR KS-D EP_AH_T_Mr-N 1540 SULLIVAN AVENUE Date: 10'30,1 SOUTH WINDSOR,CT 06074 FEE $25.00 Name of Firm , � Phone No. &0, P-9 Z 4 Address of Firm-1 I I V603 .0 - f_ ®� Zip Code CX-, 'f E a Location of proposed work M idftAbe.rW ! Describe fully nature of permit requested Starting date _ Approx.time for completion Call.Before You Dig No! aWL16®_ Existing Water Supply: ❑ Public a er ❑Well Existing Sewage Service: ❑ Public Sewer ❑ Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTHS TRAFFIC CONTROL-AND•THE-T©WN'S-CONTRACT-COSTS: THE PERMANENT PA-TOH-15 TYPICALLY- COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch of proposed work or furnish This section to be filled out by two copies of separate`kdrawing Indicate North Town of South Windsor No.cuts `�-- Est.Patch Sizes) sf Est.Pvt:Thickness in. Est.Patch Unit Price$ /sf pbi c Est.Patch Cost$ Est.Curb Replacement ft C`( r Est.Curb Unit Price$ /ft Est.Curb Cost$ _ Est.Traffic Unit Cost$ /hr 7 �jC,? Fcv�f)5 �" i t Est.Traffic Control$ Ct.S �lCt�n Amt.of Deposit$ Total Due$ u AcU foacW ( )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 WORT{ IN CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS A UTLINED IN THE WN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. tjA0 1 Signed: _ (! Date:_ 9 0' ° 1 a Title: E R eC Y 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