HomeMy WebLinkAboutStreet Cut Permits 60 Windy Hill Dr (2) 1300089 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
_ STREET CUT PERMIT
DATE: 05/13/2013 /
GIS ID: 95400060veer
MUNIS APPLICATION# 201300588 FEE: 25.00
> PIRATION DATE: 05/13/2014
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APPLICANT LOCATION
NAME: JIM FAUTEUX CONC
�j DREG 60`WIN Y HILL DRIVE
ADDRESS: 221A SCANTIC ROAD %AEI SHI I B RG NATHAN B&BARBARA
EAST WINDSOR,CI�08 6y HILL DRIVE
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PHONE INDSOR,CT 06074
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WORK DESCRIPTION: REp I �
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APPLICANT AGREES TO FURNISH THE`f-VAIOUT ' OT� BND REQUIRED AND TO REIMBURSE
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THE TOWN OF SOUTH WINDSOR FOR ANPN3E INC� �T9 �3RIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THL
FOR PERMITS AS OUTLINED IN THE TOWN IPLANIs
,I �A WSJ L ABIDE BY THE RULES AND REGULATIONS
OF �iI W ;ST }T IT ANUAL.
ISSUED BY DATA CTED INSPECTED BY
5/13/2013 2:43 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PEPMIT NO.: /3 0®0 s 9 CONTRACTOR: f m Fod�eok camas i r,
LOCATION:
TYPE OF WORK
DATE INSP NEEDED. DATE INSP:
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INSPECTED BY.--
WORK IN
PROGRESS:---/,2
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
SOUTH WINDSOR,CT 06074
FEE $25.OD
Name of Firm f a r I.3. n nc mj_e . Phone No.
Address of Firm e,e_ f c; C.1 n Zip Code
Location of proposed work 60 c,i;��G�c i ,-/.`// "t 150 f
Describe fully nature-of permit requested F:c p 1 ti LY �S(� � a-•'�� t�A 1� � C 0A cfl� �-- - ---
Starting date Approx.dime for completion
Call Before.You Dig No. Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT;INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC_CONTROL AND THE TOWWS CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch Of proposed work or famish �hls secllon to tie filled out by
two Copies of separate drawing: Inccate.Norlh Taws of Sauth Windsor
No.cuts
Est.Patch Size(s) sf
�j I�, r Est.Pvt.Tliddkness in.
Est.Patch Unit Price
# � Est.Patch Cost s
Est.Curb Replaoeme t ft
Est.Curb Unit Price a it
Est.Curb Cost$
• Est..Traffic Unit Costa /hr
RPPr�x
Est.Traffic Control s
Ant.of Deposit s
: Total DUO s
Cash O Check#
-Applicant.is-responsible-for contacting _ _ -Paid SY
the Police Dept.and C.S.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 REGUUITIONS FOR
PERMITS A OUTLINED fly THE TOWN OF SOUTH WINDSOR'S STREEfi CUT PERMIT YANUAL
Signed Date•
Title; l'l w f Driver's License#: `��/ 0�
PLEASE'ALLOW AT LEAST TWO WORKING DAYS AFTER,APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UN71L A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOSSITE AT ALL TIMES
Street Excav w Permit 08 REV 10-22-Q8