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HomeMy WebLinkAboutStreet Cut Permits 160 Brook Street (2) 1300025 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 03/19/2013 GIS ID: 14400160 MUNIS APPLICATION# 201300291 FEE: 0.00 PIRATION DATE: APPLICANT JAM LOCATION NAME: YANKEE GAS i RE ADDRESS: 112 PROSPECT HILL ! �D `, I0 BR7OK STREET EAST WINDSOR,C L1 = EI *RAT N JOHN A I C K RY DR Umq- LASTONBURY, CT 06043 PHONE 860-292-2242 WORK DESCRIPTION: REPAIdi Ijo 1IyUE� APPLICANT AGREES TO FURNISH THE Jl T?W OF SQUT I�-a- -QltfflmA g ND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR AID EXPN3ESCCI TI ©MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THU PUc4K-jS� 3 V1L L ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN Oft-60T�I WINI Rs f1 T UT pF tMIT MANUAL. ISSUED BY DATE-INSP`FCTED INSPECTED BY 3/19/2013 8:34 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** pi q i ., k� % TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: CONTRACTOR: LOCATION:--I�O TYPE OF WORK: DATE INSP NEEDED: DATE INSP: !a3 INSPECTED BY: WORK IN PROGRESS: ✓'a-lve SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE:AW\\e� S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION APPLICATION FOR STREET EXCAVATION PERMIT A 1.No. `TOWN OF SOUTH WINDSOR Permit-No. PUBLIC WORKS DEPARTMENT rif 1540 SULLIVAN AVENUE Dater SOUTH WINDSOR,CT t>6074 +E'$25 00 . Name of Firm Phone No: ® 5�— 'c � Address of-FirmL Zip Code Location of proposed+nrork Describe.-fully rrature.of permit;requested 14jk i+(` d Starting date �( Approx.ime for completipP Call Before.You ig No: 7 `,I�xisting Water Supply: ]Public Water. ❑Well Existing Sewage Service Q"Public Sewer ❑Septic PLEASS Not% THE OFPOSIT FOR.THE'PWMANENTPAVEMENT PATCH AND�CURB REPLACEMENTIS A :PRELIMINARYIRST11 E. THE APPUGANTIS-RESPONSIBLE FOR THE FULL: INA4COST OF THE PERMANENT PATCH ANp-URS'REPNACEMENT;.INCLUDING ANY INCREASES IN PATCH AREA,CURB. ' . LENGTH TRAP¢7C:CONTROL AND THI: 'QWN'S Ct7NTRACT COTS. THE PERMANENT RATCII IS TYPICALLY 7COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULJD-BE LATER THAN A;YEAR Show sketch of proposed work or furnish Thin section o be fHled out by ? two dot*$of separate drawing Indicate.North ToWc.of South WMdsor No.cuts Est Patch Size(sj sf Est.F' t.Thickness in. Est.Patch Unit Price$ /sf +. :Est.Patch Cost$ Est.Curb Replaoe nent`�ft Est.Curb Unit Price$ /ft 'Est.Curb Cost Est.Traffic Unit Cost$ fir . Est.Traffic Control$ Amt.of!)V"it$ Total Due S ( j Cash ( j Check# Applicant is responsible for contacting Paid By the 11ce:ffe f and CS.YD. 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 WLL ABIDE BY THE RVLESAMD REGULATIONS FOR. PERMITS UTI-10b IN-T OWN OF SOUTH WINDSOl` 'S STREET Q.V P IT UAL. Signe Date: <7 Title: Drive►°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 iossr E AT ALL TIMES Street Excavation Permit 08 REV 10-22-08 1 1 f j Q rO i 174 s co" A k s � 10 5 m P2989 / m i 3 2" X IP 1962 Fg a O #K38-06 0 1 16 76, 21.0 W o ® O ^^^ 1:500 1 t 4 if ;f � f t` t i 174. ��l I s� PO' 1 A � I P2989 m ®cb o 2" X IP 1962 0 #K38-06 t 1 N J) 7E Irl ol sq o _o zr.o �-U O ® C) 15�