HomeMy WebLinkAboutStreet Cut Permits 9999 Rosemary Lane (2) 1300287 TOWN OF SOUTH WI
PERMIT NUMBER N D S O R, C T
STREET CUT PERMIT
DATE: 11/18/2013 -- --- - ..
GIS ID: 77409999
MUNIS APPLICATION# 201301708 = FEE: 25.00
- EXPIRATION DATE: 11/18/2014
APPLICANT LOCATION
NAME: TELE-NETWORKS -
ADDRESS: 31 BAKEWELL COURT = ADDRESS' � � L,atill✓
CRASTON,RI 02921 ' OWNER = TO (3F SOUTH WINDSOR
1540 -u FLIVAN AVE
PHONE 401-461-8420aw &WINDSOR,CT 060742734
WORK DESCRIPTION: REPLACE 9XISO RGRCHNj GATU32
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APPLICANT AGREES TO FURNISH THE TOWNLOF SOUTH WNDSOX THE AMC U�IT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY E ENSES INCURRED TOWN Fd"XINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THHAPIiLIANT IS FAMIAR WIC HkND t�VII L"ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUS H WINDSR SSTREET--CUT 1�R tMI MANUAL.
ISSUED BY DATE INSPECTED /
INSPECTED BY
1 1/1 8/2013 3:12PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: ►-5OOaS CONTRACTOR:_7 e IP, - 4)�+w0rVs
LOCATION: R 0 SC rmat fi Nc
TYPE OF WORK: 2.r p Lc,q_ CA Tv I-,�s
DATE INSP NEEDED: DATE INSP: I- --/l/
INSPECTED BY: B Lb
WORK IN
PROGRESS: ,T.v 2-
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AS-BUILT:
INPUT: c DATE: l
W/2007 Town of South Windsor INPSEMON REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
6C>6 L SOUTH WINDSOR, CT 06074
FEE $25.00 y
Name of Firm lf�� ' \"� Phone NoA (�88 -?q1;- 2-30Z
Address of Firm-ala =W Zip Code L9 3
Location of proposed work N
Describe fully nature of permit requested do(-aa ex S' 1n cj CHTV IV) � 1Z •li
Starting date Approx. time for completion G C.
Call Before You Dig No. 00 t-l1 Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
0 No.Cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price
Est.Patch Cost$
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 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
CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLI �THEOF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signe Date: l`f N0\1 2613
T le: 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
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