HomeMy WebLinkAboutStreet Cut Permits 986 Pleasant Valley R (3) 1300248 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 10/01/2013 _ r
GIS ID: 72900986 FEE: 25.00
MUNIS APPLICATION# 201301414 'IRATION DATE: 10/01/2014
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APPLICANT LOCATION
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NAME: JAMES THROWE DBE / RE A �LI;QSANT VALLEY ROAD
ADDRESS: 97 RIVERSIDE DRIV]f I XVJS IRISTOPHER L
VERNON ROCKVILIT I)6 Cs / PLEASANT VALL RD
1JTVINDSOR, CT 06074
PHONE 860-289-0095 �% % -
WORK DESCRIPTION: EXTANof t� 1I1�'EOR I R'---
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APPLICANT AGREES TO FURNISH THE TWF` ( UTH bllsitN1( $ ID REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANIISCtJ TIRIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE�ly JS f IAR I A 1 W L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN T MANUAL.
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ISSUED BY DATE, P-VCTED INSPECTED BY
10/1/2013 2:53 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR:_7_
LOCATION:
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TYPE OF WORK:- &v' 4enA L4 use
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: Ab
WORK IN
PROGRESS: TjM T-krcye- ga FaR.c_j�r_,u+`v, 5"Opp c.46
Alo na Pieesfpq,�- yo, �"/�d
a to ��Lt5 �p ✓° �_� -e a le .2 �� Cleow 44�
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:. ����
W12007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
App1. No., TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT ', ,l
'1640 SULLIVAN AVENUE Date:
1-3
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Finn an j .t �z� Phone No. Ez 2 �
Address of FimL Zip Code 6Q(-a�
Location of proposed work
Describe fully nature of permit requested .
Starting date 20cr t 3 Aw-ox.time for c omptetion y 1
Call Before You Dig No.,701 3 ybacs y:SS. Existing Water Supply; 0 Pubric Water ❑Well
lsting Sewage Service; 0 Public Sewer Septic
PLEASE NOTE THE DEPOSIT FOR THE PERMANENT AVEMENT PATCH.AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE;FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH;TRAFFIC OONTROL AND THE TOWN'S:CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish -
Jibs seationao be filled out by
two copies of separate drawing Irdcate.Nodh Town of South VYindsor
No.cuts
Est.Patch Sizes) sf
Est.Pvt.Thickness in.
zo // Est.Patch Unit Price$ !sf
Est-Patch Cost:_
Est.Curb Replacement ft
Est.Curb Unit Price /it
Est.Curb Cost t
Est.Traffic Unit Cost$ Ihr
'�' - Est.Traffic Control
ArnL of Deposit i
Total Due i
Cash O Check
Applicant is responsible for contacting Paid By
the Police t.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
CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: .. 13
Title: L✓7Ze-�' Gv 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 ONJOBSrTE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08
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