HomeMy WebLinkAboutStreet Cut Permits 35 Garnet Lane (2) 1300117 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/29/2013
GIS ID: 34800035 ter/ AW
f FEE: 25.00
MUNIS APPLICATION# 201300714Amm EXPIRATION DATE: 05/29/2014
APPLICAN`
,ice LOCATION
NAME: ADVANCED CONSTI 1JC I(AN DRES' 5 A&ET LANE
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ADDRESS: 5 CHESTNUT HILLS BEICHI10R BRIAN O&BARBARA G
STAFFORD, CT 0607 i 35 fR1 ET LANE
% INDSOR,CT 06074
PHONE 860-519-8442
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WORK DESCRIPTION: IN SA W---4 1 ILCt�� ZII
APPLICANT AGREES TO FURNISH THE POW F SOUTH I �L'AIvI( T(F B ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANC EftR- I S ICI "t������F�( I� RIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THIyAI PI _CAT�T ISM' L�I W. A WL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OIsJt3TUIN �� ET IsEIIT MANUAL.
ISSUED BY DAS�ECTED INSPECTED BY
5/29/2013 11:55 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 001 j1 CONTRACTOR:A
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LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: f'$L-5- 3
INSPECTED BY:_ 11,,
WORK IN
PROGRESS:— '
O
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: c V DATE:_
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.,
PUBLIC_WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: ;L Z4 i 20l
SOUTH WINDSOR,CT 06074
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FEE $25.00
Name of Firn Co i!54'� Ir%Effnn*7 Ser*004- Phone No. �9 9 4114
Address of firm r Zip Code��-�
Location of proposed work Y' �'
Describe fully nature of permit requested
Starting date _g�f i eta Approx.time for completionr�
Cali Before You Dig No.e)-J� !Da A C Existing Water.Supply: Public Water ❑Weti
Existing Sewage Service: [I Public Sewer ❑Septic
PLEASE NOTE; THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH;TRAFFIC-CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
-Show sketch of proposed work or fumish
two copies of separate drawing This section to be filled out by
lydicate.North Town of South Windsor
No.cuts
Est.Patch Sizes) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
PO r Est.Patch Cost s
Est.Curb Replacement ft
Est.Curb Unit Price_$_ /it
Est.Curb Cost$
O�Gf
Est.Traffic Unit Cost$ /hr
Est.Trafflo Control t
�^^ j Amt.of Deposit$
lam" t •� L l� Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting Paid B
the Police t.and C.B.Y:D, y
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
TOWN OFFS
TH. SOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECT THI PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS TLINED THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date�- , f! f
Title: Driver's License#:
PLEASE AL. W 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 P"10-22-08