HomeMy WebLinkAboutStreet Cut Permits 220 Kelly Road (4) 1300177 TOWN OF SOUTH WINDSOR
PERMIT NUMBER C T
STREET CUT PERMIT
DATE: 07/17/2013 /
GIS ID:49500220
MUNIS APPLICATION# 201300982 - - FEE: 25.00
E*IRATION DATE: 07/17/2014
APPLICANT ' - '�
NAME: KRULL CONSTRUCTIO1, � LOCATION
ADDRESS: 44 ELM STREET �% ORES 2D fELY ROAD
= 3ER3 DI,UUOLNSKI BRYAN J&AMY L
SOUTH WINDSOR, CT W-J74
ld-lkt 2'ROAD
t V 4 PHONE 860-558-6756 �� = 9 -NDSOR, CT 06074
WORK DESCRIPTION: DRIVU)4W Ba
APPLICANT AGREES TO FURNISH THE TO OF�pUTgy�����T� �IO �OF BAD SQUIRED AND TO REIMBURSE
PEE INUI� ,B� IIE TO' E9R M
THE TOWN OF SOUTH WINDSOR FOR AN1AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THNI)OLIVANTJS FAM I I'W1 IAN1 WIh ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S9UH WI �I�' TRECU�PERMIT MANUAL.
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ISSUED BY DATE INSPECTED INSPECTED BY
7/17/2013 9:12 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1300 01 CONTRACTOR:
LOCATION:_ A e} O leLf'11 y uQ
TYPE OF WORK:_ 17. t'\VIP- t1I
DATE INSP NEEDED: DATE INSP: i - ► r
INSPECTED BY: �_
WORK IN
_ _ jT PROGRESS: b f; _� ,y.'_. ra
T1 i
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: CY '\ DATE:
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 SU'LLIVAN-AVENUE - - -- - - - Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm 6044j Phone No. ��y?'67���
Address of Firm- Sl f7 Zip Code !�Ov
Location of proposed work 2 2-0 eg
Describe fully nature of permit requested •r~ '
Starting date_& Approx.time for completion 71
Call Before You Dig No. err Existing Water Supply: ❑Pub fic Water ❑Well-
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSITFOR THE PERMANENT PAVEMENT PATCH,AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH;TRAFFIC.CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD 13E LATER THAN A YEAR.
Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost;
L j Est.Curb Replacement ft
Est.Curb Unit Prim.$_ /ft
Est.Curb Cost$
/ Est.Traffic Unit Cost$ /hr
2' Est.Traffic Control$
Amt.of Deposit$
Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police Dept.and C.S.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 ASIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OU N . IN TH OWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
2
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Signed: Date. -
Title* = �" ? Driver's License#:
Pt' SE 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 JOSSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08.