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HomeMy WebLinkAboutStreet Cut Permits 30 Quail Run (2) 1300037 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 04/04/2013 �i� GIS ID: 74400030 MUNIS APPLICATION# 201300370 f/ �� FEE: 25.00 �� LPIRATION DATE: 04/04/2014 APPLICANT irl - h LOCATION NAME: ADVANCED CONSTR fQCTIGN; A DRE - 30 l0b& RUN ADDRESS: 5 CHESTNUT HILL RA J jE IiIX L RNE&KEESHA A STAFFORD, CT 0607 It RUN W-11--a WIN PHONE 860-519-8442 WINDSOR, CT 06074 - J WE WORK DESCRIPTION: %INSTARj� %%, i� � ff APPLICANT AGREES TO FURNISH THE V P.—SouT �I1 ( OND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANC ELF �� Er � q�JTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND TH11T IS W ��filL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN Os-s(SiIV31 CI _ IT MANUAL. 116 1,4 ISSUED BY D YED INSPECTED BY 4/4/2013 11:45 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** �i s i o , i %/ i% la -104 lk Iwo r TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: /3 0003 7 CONTRACTOR: &j'Vd t Gad ca p's n2 LOCATION: .30 &i a l I l t. o TYPE OF WORK: 1'q V DATE INSP NEEDED: DATE INSP:_ /3 INSPECTED BY: f3D WORK IN PROGRESS: SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: I 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 Date: SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm A� W� L(0 C OV' �. LX-1` )lee(���� Sl�- Phone No.c OLC Address of Firm C 1-ke SI flQ 1 1-� �. ���C � 2_ Zip Code 0% Location of proposed work Describe fully nature of permit requested 1V�S-1� 11 ?)o 0 m'L Aw vv Starting date ii, c? Approx. time for completion Sf 10 Call Before You Dig No. Existing Water Supply: Public Water ❑ Well Existing Sewage Service: ❑ Public Sewer ❑ Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch of proposed work or furnish This section to be filled out by two copies of separate drawing Indicate North Town of South Windsor No. cuts Est. Patch Sizes) ___ __sf Est. Pvt. Thickness in. Est. Patch Unit Price L I Est. Patch Cost Est. Curb Replacement It Est. Curb Unit Price$_ __/ft Est. Curb Cost .Y Est. Traffic Unit Cost$, /hr © Est.Traffic Control $ Amt. of Deposit$ Total Due ( ) Cash 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: Date: Title: Driver's License tt:_____ 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