HomeMy WebLinkAboutStreet Cut Permits 11 Rosemary Lane (2) 1300168 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/15/2013 "
GIS ID: 77400011 FEE: 25.00
MUNIS APPLICATION# 201300969 tXPIRATION DATE: 07/15/2014
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APPLICANT ;" LOCATION
NAME: TELE-NETWORKS Of
�DRES 11 I€�SI MARY LANE
ADDRESS: 31 BAKEWELL COUN 'T -
��� RQDNEAALICE B
CRASTON,RI 02921 -%
�1 � E- ARY LANE
-OI.JTKV INDSOR,CT 06074
PHONE 401-461-8420eq
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WORK DESCRIPTION: REPAA INSa bl,
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APPLICANT AGREES TO FURNISH THE T?WI 1� T1ij- ;
� �'�MO� 01 D REQUIRED AND TO REIMBURSE
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THE TOWN OF SOUTH WINDSOR FOR ANC E P> ESN iTIII TAW T---OR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TH1 1PPl tckq IS R ��W.IT AN
I�WIC ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN Oft-O' - CHT PER I T MANUAL.
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ISSUED BY Lj DAT MPEf D INSPECTED BY
7/15/2013 9:26 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: . 0 CONTRACTOR: � LG�I",��5
LOCATION: ge yn(t r u Ca
TYPE OF WORK: 2 C J � �-I 1CA -TV
DATE INSP NEEDED: DATE INSP: T a3 6_3
INSPECTED BY: 8D
WORK IN
PROGRESS: ��� �� y � �e�•,
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: �A�.� DATE: �1
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: JA I I
SOUTH WINDSOR, CT 06074
✓�f FEE $25.00
Name of Firm Wc3f-k S Phone No. 'on o2 5-1 �
Address of Firm ( ( r r Zip Code 4c7' qc) /
Location of proposed work ( - 3q N
Describe fully nature of permit requested Qr- r Tns 11 SAT V
Starting date 16 1,2013 Approx. time for completion
Call Before You Dig No. oqo 13 0��d� q f�3 Existing Water Supply: ❑ Public Water ❑ Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
0 No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est. Patch Cost$
Est. Curb Replacement ft
Est. Curb Unit Price$ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
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 THI ERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OU I THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: �y� ( ` . 2 01 S
Title: 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
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