HomeMy WebLinkAboutStreet Cut Permits 20 Autumn Drive (3) 1300152 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/27/2013
GIS ID: 06000020 FEE: 25.00
MUNIS APPLICATION# 201300894 Ar NPIRATION DATE: 06/27/2014
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APPLICANT - LOCATION
NAME: AIROLDI S INC. DRE!S AUT TMN DRIVE
ADDRESS: P O BOX 71 %
/ El 4-1 FFN&J SCOTT&DEBORAH T
SOUTH WINDS0R, CT l�0'-4 0 A T i MN DRIVE
/i �lMl INDSOR, CT 06074
PHONE =.,,,, -. /
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WORK DESCRIPTION: DRIV W
APPLICANT AGREES TO FURNISH THE I=) _&jAkSOUTIT AMOY f CF$ 1D REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN EI�IrN�S1 SN �) HFQUrpR MAINTENANCE OR REPAIR WORK IN
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CONNECTION WITH THIS PERMIT AND THLAPPLCAIT IS 1= 1t�RVI �1N WL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OFASO T WftRR' F,CT�TPEi)&MANUAL.
nto 1!D �
ISSUED BY ATED INSPECTED BY
6/27/2013 11:08 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: DO% CONTRACTOR,
LOCATION:
r
TYPE OF WORK:. y�o
DATE IIVSP NEEDED:
DATE INSP:
INSPECTED BY: (j1�
WORK IN
PROGRESS: 4
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:--- - ��\�`�
S/FORMWOWN OF SOUTH WINDSOR INSPECTION
R
j APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1640 SULLIVAN AVENUE Date:. 13
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm Phone.No.
(� ` O b �
-mil. - a7F L� V�. '.HCT�S�r W�JG
Address of Firm � �P
Location of proposed work—slo
Desaft fully nature of permit !2�
date �. �`3 . x._timefor
Starting . . Appro completion
Cal(Before.You Dig No.' �„baac�S t Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service• 0 Public Sewer _❑Septic .
P,LEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND ClRimpLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL pNAL COST OF THE
PERIkANENTPATCH AND CURB REPLACEMENT;INCLUDING ANY INCIMSES BI PATCH AREA,CURB- •
I.ENQTH,?RAFFIC>CONTROL AND THE TOWNS-CONTRACT COSTS. THE PERMANENT PATCH IS TYNCALLLY
COMPLETED WITHIN A=YEAR OF THE TEMPORARY PATCH BUT IT COULD CE LATER THAN A YEAR.
Show sketch of proposed work or Banish Th_I_s aecdon so be filled out by
two copies of separate deawft: k d cate.North T rO.of Bomb tilM�dsor
No.cuts
Est.Patch Sizes) - sf
i
Est.Pit.lhiduwss in.
Est.Patch Unit Price !sf
: EeL Patch Cost S
Est.Curb Replaceamt - ft
Est.Crab Unit Price S /It
` Est.Curb Cosh
- 59 Est..Traffic Unit Cost$ Ihr
Est;Traffic ConW Z
AWL of Deposit$
Total Due 6
Cash O Check#
Applicant is responsible for oontaciing Paid By
the Police DW.and C.S.Y.D..
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 SY`THE TOWN.FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND.THAT 1 AM FAMILIAR, D E
WITHAND WILL ABIDE BY THE-.RULES.AN RGULATIONS FOR.
PERMIT OUTLINED IN,THE TOWN OP SOUTH WINDSOR'S MEET CUT PER MANUAL.
Signed:
Driver'slicense#:
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
stred:Excmtton Pemdt 08 RW 10-22-08