HomeMy WebLinkAboutStreet Cut Permits 73 Beelzebub Road (2) 1300151 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 06/26/2013
GIS ID: 09000073 FEE: 0.00
MUNIS APPLICATION# 201300884 EXPIRATION DATE:
APPLICANTeQmw — LOCATION
NAME: YANKEE GAS
j DRES T3'VEIZEBUB ROAD
ADDRESS: 112 PROSPECT HILL � / IER CWAY ERIC G&MAURA C
EAST WINDSOR,CT- 8 % '� 3 �L EBUB ROAD
= GU WINDSOR CT 06074
PHONE 860-292-2242 '
WORK DESCRIPTION: INSTAI-VGA VI
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APPLICANT AGREES TO FURNISH THE I $QUTN WE MOLT OV,BfND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANC E P I� I;S I�I�; L TB N61*OR P"TENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THLPLGAN1 IS P�AAR WJL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN O �LT41VNI;R' TR � -PERMIT MANUAL.
ISSUED BY DATFINSPEMED INSPECT�BY
6/26/2013 11:35 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1:3 601S( CONTRACTOR: \Ja Y7
LOCATION: -7 3 Z e t y�h
TYPE OF WORK: I n<%-q 11 �S U) cP
DATE INSP NEEDED:
DATE IN;SP;
. INSPECTED BY: � .
WORK IN
PROGRESS: A S -
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: CN^' DATE: Q /
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
06/25/2013 TUE 14: 00 FAX 860 292 2202 0002/002
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No- TOWN OF SOUTH WINDSOR Permit No:
PUB LIG WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: 1 "r 5-jnp
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm s V1 a _ 6(;-5 Phone No.
Address of Firm n)S n P C� �I Q j i dz Cyr" Zip Code C3 C, D &- 8
Location of proposed work
Describe fully nature of permit requested _." ii
Starting date .3 40 Approx.time for completion
Call Before You Dig No. --2O 13., Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH;-TRAFFIG -ONTROL-AND-T4iE.TGWNtS•GGNT-RAG-T COST^a: THE-PERMANENT PATGH-IS-TY-PIGALLY
COMPLETED WITHIN,A YEAR OF THI;TEMPORARY PATCH 13UT IT COULD 13E LATER THAN A YgAiR.
Show sketch of proposed work or furnish
This section to be filled out by
two copies of separate drawing Indicate North Town of South Vindsor
No.cuts
Est_Patch Sizes) sf
I Est_Pvt:Thickness in.
I Est.Patch Unit Price$ Isf
Est.Patch Cost$
0L ` Est.Curb Replacement_it
t Est.Curb Unit Price
f
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control S
K1�t Amt.of Deposit$
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 A O TLINED IN TOE TQWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signs Ad__ Date:
Tit1e:_�1 � L 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.lOBSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08
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