HomeMy WebLinkAboutStreet Cut Permits 9999 Strong Road (2) 1300021 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 03/15/2013
GIS ID: 87009999
MUNIS APPLICATION# 201300280
FEE: 0.00
EXPIRATION DATE: 03/15/2014
lk
APPLICAN At"'
LOCATION
RE
NAME: GERBER CONSTRUG�TON�O
993 STRONG ROAD
ADDRESS: 1 NUTMEG DRIVE Ek. I OAT OF SOUTH WINDSOR
ELLINGTON,CT 06(29
LIVAN AVE
PHONE 860-875-6684 VINDSOR, CT 06074
WORK DESCRIPTION: CUTS 1 IOL
6RSflTIQ�iNOJECT NO FEE
APPLICANT AGREES TO FURNISH THE TVaI-0F SOUTH
�IE1M71`Jh1T DID a— ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A gOI�VIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THAPPCANT IS ` LIAR��3�IT
FOR PERMITS AS OUTLINED IN THE TOWN ORN& WIFjF� T PE WALL ABIDE BY THE RULES AND REGULATIONS
IT MANUAL.
ISSUED BY DATE TED `�-
INSPECTED BY
3/15/2013 8:27 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
/
i
�7
All'
j o /
i
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.- J i CONTRACTOR: �Y be
LOCATION:
TYPE OF WORK: -r,9 Lv
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS: o H:e r o 40 Rd
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: f AAA DATE: la)'�
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:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm_ �� �. Dr.`s{� ���,� ( r5...,.... _Phone No., Ybl-)--Y75-6,L
Address of F1rm� i )�Jx p 1, l� !l, s46 ti, _i .....:�,_ dip Code C,: )
Location of proposed wo ;
Describe fully nature of permit requested__' mom/
Starting date Approx.time for completion
Call Before You Dig-No. - o7e/3 1,96 W,-� Existing Water Supply. p Public water 0 Well
Existing Sewage Servloe: 0 Pubiic.Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PREMINARY.ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE.FULL FINAL CAST.OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH-AREA,CURB
-LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS.-THE PERMANENT PATCH is TYPICALLY
COMPLETED WITHIN AYEAR-OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN.A YEAR.
.Show slotch of proposed work or furnish Phis section to be f ed out by
two copies of separate drawing irx#cate.Nortt► Y=of-South Windsor
No.cues
Est.Patch Sizes) sf
f 1 p Est.•Pvt..Thi*ness in.
Est.Patch Unit Price$ /sf
Est.Patch-Cost$
Est.Curb Replacement ft
Est.Curb Unit Price
Est.Curb Cost
Est.Traffic Unk.Cost$
Est.Tmfflo Contra)$
AML of.Deposit$
Total Due$
{ )Cash ( y Check#
Applicant is responsiWe 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
CONNECTIQN WITH THIS PERMIT AND THAT 1 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLINED IN TO'(VN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL
Signed; Date__
Title:-- 2L r'b I�Q� _ 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
Stud I.502vavon Permit 08 P V'10-22=Q8