HomeMy WebLinkAboutStreet Cut Permits 1105 Strong Road (2) 1300163 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/09/2013 -
f
GIS ID: 87001105 FEE: 25.00
MUNIS APPLICATION# 201300953 EIRATION DATE: 07/09/2014
APPLICANT i ;/ 3 LOCATION
y�y
NAME: CAS CONSTRUCTION �1 �� DRESS 1 05 STRONG ROAD
ADDRESS: 500 FOUR ROD ROAD = MQ SOPW ISCILLA
BERLIN CT 06057 / '� s
;�019TIONG ROAD
ff
�� umilNDSOR,CT 06074
PHONE
WORK DESCRIPTION: DIG ICII CANNA
� 'I3NICIES
AF
"
APPLICANT AGREES TO FURNISH THE TW� CUTI AMO1Ifi D $AND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANI%�EFNI � tN�RTAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TH1Af1S to W ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN O IT MANUAL.
/1
ISSUED BY DATA TED INSPECTED BY
7/9/2013 3:22 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
At AF-
i i fi
G °
i
i
ma
is y f ;
i
i/
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 00/(o3 CONTRACTOR: CQ 0 519 _
LOCATION: SAY'190 G
TYPE OF WORK: D j Irvr r �I iP�o►�e of �'�P C_ fits► °S
DATE INSP NEEDED: DATE INSP: 7/161i3
INSPECTED BY:
WORK IN
PROGRESS:_ /�,:� o�i-a c .r s�f. d ' s fir ' C'J
it
c —
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: I1 - DATE: 2
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR STREET EXCAVATION PERMIT
Appl.No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1640 SULLIVAN AVENUE Date:�� s
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm _C Phone No.� C�Z 2 Lz
Address of Firm `5 U u l vu e- 12 Q o a n Zip Code U 6
Location of proposed work 11 L
Describe fully nature of permit requested w -r/'c s
+C G �.
Starting date 3-MA7 ► . Approx.time for completion,
Call Before You Dig-No. JI q 3 Existing Water Supply: ❑Public Water ®Well
Existing Sewage Service: 0 Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PREL.IMINARY.ESTIMATE..THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST.OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCHAREA,CURB
-LENGTH,TRAFFIC CONTROL AND-THE TOWN'S CONTRACT COSTS.-THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR-OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN-A YEAR.
Show sketch of proposed work or furnish This section tote fitted out by
two"copies of separate drawing Indicate.North Town of.South Windsor
_ - No.cuts
Est.Patch 51ze(s) sf
Est.'Pvt.Thickness- t/ in.
atch Unit P Est P rue$ /s#
Est Patch-Cost'$T l/
_. Est.Curb� - Replacement ft
1
Est.Curb Unit.Price
Est Curb Cost..$
Est.Traffic Unit Cost$ Air
Est Traffic Control$
Amt.of.Deposit$ X QU
1 Total Due t. �a 10�5
O Cash O Check it 157OL 9
Applicant is responsible for contacting Paid By CAS C6AS4: 42,
the Police Dept and C.B.Y.D.
I AGREE TO FURNISH TO THE TOWN. SOUTH WINDSOR THE AMOUNT OF BOND REQUiRI=D 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 AS OUT'UUNNED IN THE TOWN OF SOUTH WtNDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: �1�3
.Title__ C,,J A Driver's License#: o.S ±t Z 3
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 dOBSITE AT ALL TIMES
sbraet Excavatlon Pem9t 08 RET10-22-08
9
�,
.�� ��
lC ��
.�' r
s
t
d
�� � N
"� ....
;.,
'4
''
....._._._--.--�--�-- S�