HomeMy WebLinkAboutStreet Cut Permits 993 Pleasant Valley R (2) 1300060 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 04/22/2013
GIS ID: 72900993
MUNIS APPLICATION# 201300482 FEE: 0.00
MPIRATION DATE:
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APPLICANT-' - � LOCATION
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NAME: YANKEE GAS Ay� %ADDRESS- 99PLIISANT VALLEY ROAD
ADDRESS: 112 PROSPECT HILL, I ' %�
� �EI� P�PAPIIITRO SUSAN M&
EAST WINDSOR CT-I
y 9� � -= ESANT VALLEY
! � IJTIIINDSOR CT 06074
PHONE 860-292-2242 / j
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WORK DESCRIPTION: AR
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APPLICANT AGREES TO FURNISH THE TV-
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THE TOWN OF SOUTH WINDSOR FOR AN WE /O� �lD REQUIRED AND TO REIMBURSE
T6NdR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THLAT IS WL AJ ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OCi IV . C IERT MANUAL.
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ISSUED BY DA "ED INSPECTED BY
4/22/2013 9:55 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT N0.: 1 3 000&0 CONTRACTOR: c, ee ��s
LOCATION: q 1f ✓rr A ��
TYPE OF WORK: 7,v,ctn l I g�S=S r i
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: 9_7\)
WORK IN
PROGRESS:_
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: e.�_.. DATE:
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR STREW EXCAVATION PERMIT
Appl, No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIGWORKS DEPARTMENT
1640 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25-00
Name of Firm Phone No. 8too•49 Z-Z2,L4;2
Address of Firm + zip CodeDG08-S._____
Location of proposed work 9 9 3 P I`e alsa.r1 C3,l
Describe fully nature of permit requested___I rl S-F-q-1 1 Q RS Sean e�
Starting date,WftX, OT y aQ 3 Approx.time for completion D_ f
Call Before You Dig No. ZO 13/(00Y f LO- Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LfENGTH;-TRAFFIC-CONTH0 iL-AND T-IE.T{0WHFS.CONTRACT-COSTS: THE PERMANENT PATCH IS�TYPICAL-LY'
COMPLE�D'IIWrMIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A Yf". a
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
t' Vatley Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Pace$ Isf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price
Est.Curb Cast$
nq,� Est.Traffic Unit Cost$�/hr
"t Sk"Lt Est.Traffic Control$
Amt.of Deposit$
Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police D t.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: l LJ Date, �j
Tale: Driver's License#:
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPI.ICxnoisi FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavatlon Permit 08 REV 10-22-08
ZO/ZO 39Vd 69ZZZGZ0986 TZ:ZT ETOZI6T/170