HomeMy WebLinkAboutStreet Cut Permits 200 Deming Street (6) -- -
1300261 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 10/11/2013
GIS ID:27600200 FEE: 25.00
MUNIS APPLICATION# 201301478 _ EXPIRATION DATE: 10/11/2014
APPLICANT LOCATION
NAME: FOLSOM CONSTRUCTIONLI C ADIFES 200;DE1ING STREET
ADDRESS: 138 RYE STREET 01ER D�MING"PLAZA LLC
SOUTH WINDSOR, CT 0 4 92 MARGARET AVENUE
—LAWRI NCE,NY
PHONE 860-528-8928
WORK DESCRIPTION: TAP WAJ R MAIN II ALL HYbl r1I IT LATERALAcROSS STREET INSTALL
NE W TIfRAIT _
APPLICANT AGREES TO FURNISH THE TOWN OF-SQUTH W NDSOR THE AMOUNT OF 1341)REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AA EXPENSES ING�BY IHE TO WhT FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THAPPlICANT IS FIIL IAA £HAN ILL
WI D W "ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN 0,Zt"SOUTH WINDSR'S STR1E-T=CUT PEI*MANUAL.
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ISSUED BY DATE INSPEOTEb INSPECTED BY
10/11/2013 11:25 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I ❑Oa 6 I CONTRACTOR: F-0 I SQvb
LOCATION: a 00 !be m'\O G SAYnel
TYPE OF WORK: W" Ma j n nsia II I)e w }q Vc1r0p!`r
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: 136
WORK IN `7 ' G t,
PROGRESS: 1 , Y,j Ak To
4 if`
�2C0' �� lJei 1YIlt, "10 7 �.E 11,✓�' I GICst;I L2 A,,,A
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: a�l �
W12007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: 1
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm C, f4S i R.I&;,C,ti i, i-O- Phone No. -6 -z-
AddressofFirm 1-2S S T. Scat wt.ji>5�rL T Zip Code Cc-2y
Location of proposed work -Zc-3 -0&"i,J(= s 7
Describe fully nature of permit requested 'TA-t-) (A ATe(L i/Q 5 T'A Ll. r-i V D(L A^YT- J-A-(E n.ALL
A(.(Lc55 S 9*1 y t/4�'i
Starting date j r 3e, f 3 Approx.time for completion Z,-S O 4,-t a S 1'4 cz,
Call Before You Dig No. 'wcs I'3 c 1(,S 4 Existing Water Supply: Public Water ❑Well
Existing Sewage Service: [ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show osed-irk or furnish This section to be filled out by
o copies of separate drawing) Indicate North Town of South Windsor
No.cuts I
> / Est. Patch Sizes) -S 0 sf
C4, 0 Est. Pvt.Thickness_Y in.
Est. Patch Unit Price$-011-S--/sf
�G Walk , by droir► b h t Est.Patch Cost$ O
Gr�Gh w I d t 1C S /G h Est.Curb Replacement ft
Est.Curb Unit Price$ a /ft
4 15e o-if Cgffti 14��h y Est.Curb Cost$ CJ
/ Ale GN -��Pi l /J s �Y Est.Traffic Unit Cost$ /hr
�f Est.Traffic Control$
A1l/ a 1 A Amt.of Deposit$ Q
Total Due$_ 9
( )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 O TLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: [t 3
Title: i, MAr4C - 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 10-22-08