HomeMy WebLinkAboutStreet Cut Permits 723 Nevers Road (2) 1300190 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 07/25/2013 / /
GIS ID:62400723
MUS APPLICATION# 201301044 = FEE:
MUM SS
I;XXPIRATION DATE:
APPLICANT
LOCATION
NAME: YANKEE GAS DARES ,. ?23 4AERS ROAD
ADDRESS: 112 PROSPECT HILL— %!
1 LIER A HTAJ SAEED
EAST WINDSOR, CT1068 —= 23 VEERS RD
PHONE 860-292-2242
� wqp7ITAmmfFI INDSOR, CT 06074
WORK DESCRIPTION: INSAL—ENE AS ICI
p
APPLICANT AGREES TO FURNISH THE 1 W DF SOUTI . I}5ORA 1, AMQtT T O�B �ID REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANC E MI>NSI S INC H o TW�6_ VOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THIPPLUANTIS ILIA WT�fAB�i gBIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN Oli7I� yVII�I 'SIRE �[IT pE1vIIT MANUAL.
ISSUED BY DATBPECTED INSPECTED BY
7/25/2013 9:16 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 13 00 C CID CONTRACTOR: N a VI ►�S�
LOCATION. `7 a.3 we1S Y G (
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: 0 13
INSPECTED BY: 9b
WORK IN
PROGRESS: 1 7 �x .2-1 T A e_ye,g
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: " DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
07/24/2013 13:03 98602922269 PAGE 02/04
Appl,No. APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR Permit No,
PUBLIC.WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.OQ
Name of Firm Phone No.,�
Address of Firm / f�i���
Location of proposed work Zip Code
Describe fully nature of permit requested
Starting date Approx,time for completion l
Call Before You Dig No. �l Existing Water Supply: El Public Wake ❑Well
Existing Sewage Service: ❑Publio Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURS REPLACEMENT IS A
PRELIMINARY ESTIMATE, THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL,COST OF THE
PERMANENT PATCH AND CUR13 REPLACEMENT,INCLUDING ANY INCREASES IN PATCH,AREA,CURB
LENGTH T4RAFFIG.-CONTROL-AND-THE T4OWN'S•GONTRACT.GOST'S. T14E.PIERMANRNT..PAT40H.IS TY-PIGA LLY
COMPLETED W11'HIN A YI?Al3 OF THE TRMPORANY PATCIi BUT IT COULD BE LATER THAN A YEAR.
Show sketch df proposed work or fumish
two copies of separate drawing Indicate North is se of South Wi dsor b
3 No,cuts
Est.Patch Sizes) sf
' Est"Pvt.Thickness in,
Est.Patch Unit Price$ _ /sf
Est.Patch Cost$
f Est.Curb Replacement____ ft
Est.Curb Unit Price$_/ft
Est.Curb Cost$
� I
I Est.Traffic Unit Cost$ /hr
TXq
Est.Traffic Control$
Aml,of Deposit$
Total Due$
( )Cash ( )Chcok#
Applicant is responsible for contacting. Paid By
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 REGULATIONS FOR
PERMITS AS�TLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL..
Signed: Date: oZ
Title; c - r- 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 Penult 08 REV 10-27-O8