HomeMy WebLinkAboutStreet Cut Permits 339 Chapel Road (3) 1300136 TOWN OF SOUTH WINDSOR CT
PERMIT NUMBER ,
STREET CUT PERMIT
DATE: 06/17/2013
GIS ID: 18000339
MUNIS APPLICATION# 201300826 - FEE: 25.00
EXPIRATION DATE: 06/17/2014
APPLICAN I Nk
NAME: LAYDON INDUSTRIFiL ,C LOCATION
ADDRESS: 51 LONGHINI LANE �_ S �9-CH PEL ROAD
�' EI 1MfATHE NEW HAVEN,CT 0651 FAMILY LIVING TRUST
63 1 ILA ST
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PHONE ,. INDSOR, CT 06074
WORK DESCRIPTION: PENS
E1VJRI? T
� �O�AA�dAR�I�C
APPLICANT AGREES TO FURNISH THE fV OF SOUTI4R�E4 � D SQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANEI� N�SES INi T14E TODR/ TENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THL I'I CANT IS A � WI-441 WI Z ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OP�6ffi W R' TREE CIJT PER1 fIT MANUAL.
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ISSUED BY "® �� ' " '�� W2
DATLPCTED INSPECTED BY
6/17/2013 11:00 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 131001,36 CONTRACTOR: Lz urlIgn :z Y)d
LOCATION: 3.3 9
TYPE OF WORK: 2yY�inFnt
DATE INSP NEEDED: DATE INSP: t m t 13
INSPECTED BY: p�
WORK IN
PROGRESS:_ �j C u5
13 A V
c 6
SEPTIC TANK PUMPED, SMASHED,FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT.
INPUT: - DATE:
S/FORMS(TOWN OF SOUM WINDSOR INSPECTION
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm LC�-�1 . " "1 C-A�-k Phone No.
Address of Firm S1 r s11 .G: e 6C --n Zip Code OCQ'Sli
Location of proposed work `3
Describe fully nature of permit requested _� t1 �` +i®r _ �",'� �► `
Starting date o�l Approx.time for completion 1 �'-� -
Call Before You Dig No. Q��111 C111t11-4- Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est. Patch Cost$
Est.Curb Replacement ft
� - Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
( )Cash ( )Check#
Applicant is responsible for contacti Paid By
the Police Dept.and C.B.Y.D.
I AGREE TO FURNIS THE TOWN OFF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
TOWAALLOW
SOFOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONS PERMIT A THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PER THE TO N F SO TH WINDSOR'S STREET CUT PERMIT MANUAL.
Sign Date:TitleDriver's License#:
PLEAST 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