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HomeMy WebLinkAboutStreet Cut Permits 590 Chapel Road (4) 1300137 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 06/17/2013 GIS ID: 18000590 MUNIS APPLICATION# 201300827 - FEE: 25.00 E-PIRATION DATE: 06/17/2014 APPLICANT LOCATION NAME: LAYDON INDUSTRIECLLC DRES 5-96CHAPEL ROAD ADDRESS: 51 LONGHINI LANE IfF %" ET CLAD GIAA V NEW HAVEN,CT 06519 fe 5-90 I 'EL ROAD PHONE _ L7JPI INDSOR, CT 06074 i - WORK DESCRIPTION: PER1I�IT �Nmb RIT� JNE �j APPLICANT AGREES TO FURNISH THE WOF SOUTFI� IAMOF7 ( BOfND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANC E3PENsh INC 3 p T©WN'4ORM INTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND TH1'LANT IS RAC W4j WIL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OPOI3TkI WIII3SR TRCiJT pERfIT MANUAL. G IUD 1 I c/ "ISSUED — - G- BY DATL7-INg- CTED INSPECTED BY 6/17/2013 11:04 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** - �� - , f ot- ,,, TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: 1300/3 CONTRACTOR: Zaqckin .dart e-da LOCATION:_ t)rA TYPE OF WORK: �Z 'I 1� r1�n`t' QaJUPYlnen �pp j`l etOf' ►m� - DATE INSP NEEDED: DATE INSP: INSPECTED BY:_ � WORK IN PROGRESS: a/5&4, 0�% SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT:_ DATE: S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION APPLICATION FOR STREET EXCAVATION PERMIT AppI. No. TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT 1540 SULLIVAN AVENUE Date: SOUTH WINDSOR,CT 06074 FEE $25.00 Name of Firm L ? � =%--�1,-,%-JL "\ -P--% Phone No. " E Address of Firm n i ±6 --v Zip Code 04-C, ► Location of proposed work nao Describe fully nature of permit requested e Re ^ a q aa.• HMV y Starting date 1L4 6Ui -�l Approx.time for completion_ Call Before You Dig No. i Existing Water Supply: ❑ Public Water ❑Well Existing Sewage Service: ❑ Public Sewer ❑ Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch of proposed work or furnish This section to be filled out by two copies of separate drawing Indicate North Town of South Windsor No.cuts Est.Patch Sizes) sf R < �� � Est.Pvt.Thickness in. Est. Patch Unit Price Est.Patch Cost$ Est.Curb Replacement ft Est.Curb Unit Price Est.Curb Cost$ nU (-Ct j�LJL%3 Est.Traffic Unit Cost$ /hr Est.Traffic Control$ Amt.of Deposit$ Total Due$ ( ) Cash ( )Check# Applicant is responsible for contacting Paid By the Police Dept. and C.B.Y.D. I AGREE TO FURNI I TO E TOWN,OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WIN R FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION THIA ERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS O LI I THE TOWNJef SOUTH W INDSOR'S STREET CUT PERMIT MANUAL. Signed: Date: l Title: 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