HomeMy WebLinkAboutStreet Cut Permits 458 Graham Road (2) 1200215 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 11/05/12so
-
GIS ID: 37500458 FEE: 00
MUNIS APPLICATION# 201201478 EXPIRATION DATE:
APPLICANT - LOCATION
NAME: YANKEE GAS ��DDRES 4Si GRIHAM ROAD
ADDRESS: 112 PROSPECT HILL - ££ JER' = STARKWEATHER RALPH A JR&BARBARA
EAST WINDSOR, CT 0698 f la 2-t
458 GRAHAM ROAD
�90JJT
860 H V4�INDSOR, CT 06074
PHONE -292-2242
WORK DESCRIPTION: INS' b-L;AGAS RVIC
APPLICANT AGREES TO FURNISH THEQW OFIt-SOUT1_1H�1lS_AII✓TE AMQUIT OF$GRID REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXI'NSES III URI H T(}y FQR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THI APPLCQI+IT IS FBI 1Af WITH AI�I1 WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TO WN OPS6t3TLt WINDSI�`��STRi ET�IJ-T-FERAfIT MANUAL.
ISSUED BY DAPCTED INSPECT BY
11/5/2012 9:35 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1 a 00a ),S CONTRACTOR: � ay) 4ee-
LOCATION:_ q (� �'G� hc. m CA
TYPE OF All I 1 C
joe.
DATE INSP NEEDED: DATE INSP: 113
INSPECTED BY: 6SD
WORK IN
PROGRESS:_ "� X S' C, lyl'a1 4-o r r-I- 74n_
/Y.o.
S 3
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
1
INPUT: DATE: h
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
10/30/2012 TUE 12: 57 FAX 860 292 2202 14002/002
APPLICATION FOR STREET EXCAVATION PERMIT
Appl.No. TOWN OF SOUTH WINDSOR Permit No.
PUBLICWORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: if 0 l a-
SOUTH WINDSOR,CT 06074
FEE $25.QQ
Name of Firm Phone NO. (C)L3,3J 5�29?—
Address of Firm r Zip CodO&CX38
Location of proposed work r-
Describe fully nature of permit requested .:-no;5 is n aas � �"rl a
Starting date Approx.time for completion
Call Before You Dig No:AQd ALA'A CQ n 5 Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE'
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH;TRAFFIC--CONTRaL-AND•-T-FIE'•*t�WN'-S-CONTRACT COSTS: THE-PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN,A YEAR OF THE TEMPORARY PATCH 13UT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish ]his section to be filled out by
copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
CS Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
6 Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
1 E41(l e mph Est.Traffic Control$
._._ r K&L 1~QcALJ Amt.of Deposit$
ai G11 t.Q 11 :`e 4 ` '
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 1PERMIT MANUAL.
Signed: L. c Date: l0.36,
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