HomeMy WebLinkAboutStreet Cut Permits 41 Newmarker Raod (2) 1300229 TOWN OF SOUTH WINDSOR,
PERMIT NUMBER C T
STREET CUT PUBLIC UTILITY
DATE: 09/04/2013
GIS ID:63300041Xv
MUNIS APPLICATION# 201301267 = � = - FEE: 0.00
Z- 6CPIRATION DATE:
APPLICANT-
NAME: YANKEE GAS — — LOCATION
ADDRESS: 112 PROSPECT HILL I % D 41 NI WIvIARKER ROAD
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EAST WINDSOR, CT1-06�8
EX AMER BRUCE C JR&CARRIE F
91 N �VAARKER ROAD
PHONE = U-�WINDSOR, CT 06074
860-292-2242 � _ ;
AN
WORK DESCRIPTION: EXCA 11 ' 'VLI1�
FITTI ,C=f HIV IrI Tk 3V RASS TO LOCATE
APPLICANT AGREES TO FURNISH THE 1 ?W 1OUTITN � - 0 �OF B(iVD REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANC,hIs
CONNECTION WITH THIS PERMIT AND Tlibj1 &C-ANu SUS R MAINTENANCE OR REPAIR WORK IN
FOR PERMITS AS OUTLINED IN THE TOWN OIOLT WIII SIT M IDE THE RULES AND REGULATIONS
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ISSUED BY �
DATEPP TED INSPECTED BY
9/4/2013 3:51 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: i DO a a R CONTRACTOR: "-]a',Yee
LOCATION: ` , heuA,� YY1a'cy_-p(—OnA
TYPE OF WORK: �,xr c,��U°I P :fir, L.n on 6 y\—
DATE INSP NEEDED: DATE INSP: gk2Y//�
INSPECTED BY: fM
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
_ _ ----- ------ -- —-
-APPLtCATIOt�1-FOf STREET XGAVATION PERM T _----- ---_-
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540-SULLIVAN-AVENU1=. . -
Nr:... SOUTH.WINDSOR,CT 060,74.
FEE $25.00 nr
Name of Firm �� �E'. �3 a�� Phone No, Z-3"5('D - 2— (�W
Address of Firm 14ffi S VJ YA C(Dr Zip Code
Location of proposed work 41 L-etk)rWirkz2r- PA,
Describe fully nature of permit requested 'K. ` vae- hole Lwhivij
r cis
Starting date Approx.time for completion_ k-L
Call Before You Dig No. Existing Water Supply: ❑ Public Water- ❑Well
Existing Sewage Service: ❑ Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
S-e-e-
No.outs
0
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /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 THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLINED IN TH WN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
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Signed: Date: T -�
Title: `C"CC 1Cm '=E L � Driver's License#: u jo-1
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 Permit 08 REV 10-22-08
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material id redne(on this map Title:shall be considered prapri:h to
Yankee Gas and user wh'roh is
defined as any person on entity
Solhas received the map through o 0
solq, purchase,exchange,gift,or
.othprwlsej shall keep it in,confidence
and shall not furnish or disclose it
to any third party without the prior Information shown is not guaranteed and Yankee Gas assumes no responsibility. !"" '"' The Northeast Uttities System
wntten permission of Yankee Gas. contractors are urged to call Yankee Gas for further information at 1-800-989-0900 0 e: — ug— 107 Selden St.,Berlin c7 0603J l
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The aterial contained on this map
sh I�be considered pr prietary to Tine:
Yo k"Gas and user which is
def npd as eny person.or entity A
whq has rece. the map through
so -Wise)$hal eXchange,got,or oth wiae)shorn k}.p it in confidence
and.. all not furnish or disclose it
t@ pI y third party without the prior information shown Is not guaranteed and Yankee Gas assumes no reaponsihGity. ""''!' the kortheost UtWties System
written permission of Yankee Gas. Contractors are urged to coil Yankee Gas for further information at 1—e00-9 9-0900
a 9: Lg- 107 Selden St.,.Bedin Cr 6603
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