HomeMy WebLinkAboutStreet Cut Permits 226 Beelzebub Road (2) 1300222 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 08/26/2013
GIS ID: 09000226 � - FEE: 0.00
MUNIS APPLICATION# 201301214 - EXPIRATION DATE:
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APPLICANT
—� LOCATION
NAME: YANKEE GAS A €DARES Z2EIJ.ZEBUB ROAD
ADDRESS: 112 PROSPECT HILL2D COP RC�BERT W&MONIKA L
EAST WINDSOR CT-fi0= ,, = 261 E13ZEBUB ROAD
HIV V INDSOR,CT 06074
PHONE 860-292-2242 oll
WORK DESCRIPTION: INST'AL`NtW�—AS
APPLICANT AGREES TO FURNISH THE 1I W��1~sOUTITk -M0U1 OFQND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANI EXPENSES 1I�IOO�IHC� VNUR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TH API'L AN -JS IMAM i IAT A I WIL1 ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED 1N THE TOWN OF 499'U'TITWI1�16 Ra TR CUT PI I vfIT MANUAL.
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ISSUED BY DATE PECTED INSPECTED BY
8/26/2013 11:10 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1 300 0-2, CONTRACTOR: Yovn Kee-
LOCATION:
TYPE OF WORK: j vn S he Jk �-O ca o,s S��v►`
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DATE INSP NEEDED: DATE INSP: 3
INSPECTED BY: e
WORK IN
PROGRESS: o 7 C, R e e/zett,6
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AS-BUILT:
INPUT: DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
08/26/2013 MON 9: 15 FAX 860 292 2202 0002/002
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: A X2 9 13
SOUTH WINDSOR,CT 06074
/ / � FEE $25.00
Name of Firm Xff Z1� �r /L. (41r'�
Address of Firm Zip Code 20 A
Location of proposed work
Describe fully nature of permit requested r
Starting date A > Approx_time for completion_=� ,LC�
Cal!Before You Dig Na.�' l y �yo qf �( Existing Water Supply: ❑ Public WatW El Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
L•-ENGTHj TAAFFIG CONTROL-AND T!iE-T-OWN!-i-CONTRAGT-C-OST.S. THE-PERMANENT-PA7'•GHdS.TYPIGALLY
COMPLETED WITHIN•A YEAR OF THE TEMPORMY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish
copies of separate drawl This section to be filled out§y
two co
P P drawing y Indicate North Town of South Vindsor t
No.cuts
Est.Patch Size(s) sf
/ Est.Pvt.-Thickness in.
i' Est.Patch Unit Price
I
I Est.Patch Cost$
Est.Curb Replacement ft
I Est.Curb Unit Price
I
I Est.Curb Cost$
[.
Est.Traffic Unit Cost$ L /hr
I °X Est.Traffic Control$
Amt.of Deposit$
01
Total DueAL
$
( )Cash O Check#
Applicant is responsible for cont n . / r f f Paid By
the Police Dept.and C.B.Y.D.
t 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 ,. INED.IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed �,7�� Da t e:
Title: A� 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 Permit 08 REV 1D-22-08
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