HomeMy WebLinkAboutStreet Cut Permits 389 Pleasant Valley R (2) 1300245 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
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DATE: 09/24/2013
GIS ID: 72900389 / ' FEE:
MUNIS APPLICATION# 201301381 — 0.00
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'IRATION DATE:
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APPLICANT /
- LOCATION
NAME: YANKEE GAS / RE Ac,
Vk&SANT VALLEY ROAD
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ADDRESS: 112 PROSPECT HILL
# I j VER LICIA W
EAST WINDSOR, CT 6088
, 9 PLEASANT VALLEY
� J VINDSOR, CT 06074
PHONE 860-292-2242 ;
WORK DESCRIPTION: INSjf
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APPLICANT AGREES TO FURNISH THE T W1s1 1` OUT AMQU)ff(���ID REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN 'PNEC[JTH£ WI`IRIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE A LAN
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1~�IAR����AWL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OFQI1yVNDSs SR�ET � IT MANUAL.
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ISSUED BY DATE .;,PT- CTED INSPECTED BY
9/24/2013 1:23 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:._( 300aq S`J CONTRACTOR:
LOCATION: Ir0_Sa r)
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TYPE OF WORK: - 1 rx a
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS: h s X y / Cw Mum - cr �ecJ C�5
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT:. DATE:__ \g 1
W/2007 Town of South Windsor INPSECTION REPORT 07
Sep. 23. 2013 8:04PM Sargis Assoc No, 0149 P. 2/2
APPLICATION FOR STREET EXCAVATION PERMIT
Appl.No. TOWN OF SOUTH WINDSOR P rmit No
PUBLIC WORKS DEPARTMENT � �3 C3
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE �25.00
Name of Firm '117xlGe C—:5r0
Address of Firm z Inc.6S Zjp Code d 00_,q
Location of proposed workSC�r7 ,
Describe fully nature of permit requested
Starting date Approx.time for completion
Call Before You Dig Nc>�D/ 394//�T Existing Water Supply: ❑Public Water ❑Well
- Existing Sewage Service: ❑Public Sewer ❑Septla
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB RP-PLACEMENT 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
- ENGTfl x4RAFFIG-GONT-ROL-ANt)-!r-FIE-TOW-NIS-EONTftAGT=-COSTS: THE-PERIVIgNfENT-PAT-CH-ISTYPIGAL-L-Y
COMPLETED WITHIN-A YEAR OF THE TEMPORAW PATCH BUT-IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish
This secll,on to be filled out brr
two copies of separate drawing Indicate North Town of Sauth_Windsor
No.cots
^� Est.Patch Slze(s) sf
Est.Pvt.Thickness In-
Est.Patch Unit Price$ Is[
i Est.Patch Cost$
f(f Est.Curb Replacementft
Est_Curb Unit Price$ /ft
Est.Curb Cost
Est.Traffic Unit Cost$ /hr
Est,Traffic Control$
Amt,of Deposit$
Total Due$.
O as ( )Cheek#
Applicant Is responsible for contacting Paid B
the Police Dept.and C.B.Y.D. Y—
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 - T iNED IN THE TOWN F SOUTH WINDSOF`S STREET CUT PERMIT MANUAL.
Signed: - Dato: ! 3
D&ar's license
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A P'EFgMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOB SITE ATALL TIMES
Street Excavation Permit 08 REV 10-22-08