HomeMy WebLinkAboutStreet Cut Permits 11 Hanover Lane (2) 1300249 TOWN OF SOUTH WINDSOR CT
PERMIT NUMBER ,
STREET CUT PERMIT
DATE: 10/04/2013 _
GIS ID: 39600011 // ,
MUNIS APPLICATION# 201301438 �% FEE: 25.00
ja X 'IRATION DATE:
If - 10/04/2014
APPLICANT iVla
NAME: KELMAN LANDSCAPE LAC / / LOCATION
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ADDRESS: P. O.BOX 234 REST 1 hAN6VER LANE
��� = N�ISbAVID M&SUSAN R
MANCHESTER, CT 0 (1 4 / y
4 BAN( VER LANE
PHONE -- % % IIVINDSOR CT 06074
860-646-5617
mill
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WORK DESCRIPTION: PIPE tv Pum—A I
APPLICANT AGREES TO FURNISH THE T`01WFO1TI4�
THE TOWN OF SOUTH WINDSOR FOR AN�hj 0F1 BAD REQUIRED AND TO REIMBURSE
CONNECTION WITH THIS PERMIT AND THE 3AI jRAINTENANCE OR REPAIR WORK IN
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FOR PERMITS AS OUTLINED IN THE TOWN OF eft- AI W 1 ABIDE BY THE RULES AND REGULATIONS
ff ,. �' 4'I SIT MANUAL.
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ISSUED BY DA l h IIN _CTED INSPECTED BY
10/4/2013 9:44 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: -
LOCATION: IhVL°� La Yam,
TYPE OF WORK: - j m '(06
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: 1
WORK IN
PROGRESS:_
L"�Y
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
1
INPUT: DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
APPI,( TION AT
C� TR T �;-. AVO PRAT
Ap SOUTH M INDSOR Per► it No
PUBLIO V1/ORK3EPART NT
i54Q SUI.UVAN A1iEHUE DatBsf
Y StItUT`H}NII C Ott,PTV674
FEE 25.Q
Name of firmf
Addre� of, trm }
Zip.777
Cody AQ�
location of proposed
I?eseribe fully I. nature of permit requ�sed
- .- ,�
Sferttrtg tfate ,.
ARf�iOX time for completion
Cal{Before You Dl No''. / Exiting Wa#er Supply a !�o Water []Well
)=crting Sewage:ServFce: ubl�c Sewer C�Sepfic
FLEASr (VQTE ;TFiE QEPOSiT FOjt THE P RMANEN�.- AVE AiI�NT PATCH ANQ CURB REPLACEMENT
FtiEL)IMI(�ARY ESTIMTE THE APPLICANT-IS RE$PON$(BLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACE ENT,'INCLU6ING ANY M CREASES�IN PATCH AREA,CURB
LENGTH,TRAPFIG CONTROL AND THE TOVi/N'S=CbNTRAMCOSTS. -THE,PERMA1tENT PAl IS TYPICALLY ;.
COMPLETED WITHIN A YEAR(yP THI!T1=IVIPORARY PATH BWT IT.COUCD BE LATER THAN'A YEi4R.
'Show'sketeh of proposed work or furnish
two.copes of separate drawing Thls section to bg filled out by
Indicate. Town of South Windsor.
No:cuts.
Est.P.atch'`Size(s) sf
Est.M.Thickness in.
Est.Patch Unit Pace$ _ /sf
Est.Patch Cost$
A
E � f Est.Curb ReplacementWx
ft
Est:.Curb,Unit P6oe$_� it
Est.Curb_Cost$
Est.Traffic Unit Cost$ /hr.
Est Traffic Control$
Amt.of Deposit S
Total Due
py
:Cash ( yCheck#
Applicant iS respons n a Paid By
fhe Police De t.and:G.
1 AGREE.TO FURNISH TO THE TOWN OF SOUTH NDSOR THE AMOUNT OE BOND REQUIRED AND TO.REIMBURSE THE,
TOWN OF SOUTH 1NtNDSOR FOR ANY EXPENSES INCURRED CiY THE TOWN.FOR MAINTENANCE OR-REPAIR WORK IN
CONNECTION WITH THIS PERMtI'AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
F?ERMITS AS OUTLINED IN.THE TOW OF SOUTH WINDSOR'S STREET'CUT PERMIT MANUAL.
Signe 1 Date: �� ~-
Titie: /'^ '� Diver's License#: C% ry d
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
-WbRK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED -
P�RMIT SHALL BE KEPT ON JOBStTE AT ALL TIMES
meet Excavation Permit 00 Rl v 10-22-09