HomeMy WebLinkAboutStreet Cut Permits 16 Greenfield Drive (2) 1300101 TOWN OF SOUTH WINDSOR CT
PERMIT NUMBER ,
STREET CUT PERMIT
DATE: 05/15/2013
GIS ID: 38400016
MUNIS APPLICATION# 201300637 FEE: 25.00
EXPIRATION DATE: 05/15/2014
APPLICANT /
NAME: AIROLDI'S INC. LOCATION
ADDRESS: P O BOX 71 �% ' � ENFIEL DD RIVE
SOUTH WINDSOR, T 014
ER EI "-- Fk DIANE L
16 C;REINFIELD DRIVE
PHONE -- INDSOR, CT 06074
WORK DESCRIPTION:
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APPLICANT AGREES TO FURNISH THE TVV�OFpUT �� Of 4B_�ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN` I ;P �W�lM- 1AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THI PItyA1�'E�SAMIT€�A1 WL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OBI W-INSI' TTZ �1 PEAT MANUAL.
ISSUED BY DATEINSPECTED INSPECTED BY
5/15/2013 3:39 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:_ /3� .� CONTRACTOR: A) Y0)66 's
LOCATION: �� �'► ►�l J Q
TYPE OF WOWK:
DATE INSP NEEDED: DATE INSP: f- i_3 /y
I6PECTED BY. 13�
WOW IN
PROGRESS: + k e_ �
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:- _a-c
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
. ^i..1,'�%P'�r"'fi!�7�r'�V�'rs,�yy�:pyy��..:yJnvidNJ,�"tit•Y �1'.,��,; :_.* 'IY ^f,(it!;�i.`AI N'�y'�d11�,•sl;r A '•,y '1;'a���,r�'',
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APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date; S \a �
SOUTH WINDSOR, CT 06074
FEE $25,00
Name of Firm o�i� s N<- Phone No.
Address of Zip Co ed <Z:>609�t
Location of proposed work
Describe fully nature of permit requested
S t a n i n g date Approx. time for completion
Call Before You Dig No. `���3�g�� ��'� Existing Water Supply; ❑ Public Water ❑ Well
Existing Sewage Service; ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE, THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INbLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR,
Snow sketch of proposed work or furnish This sectlQn Jo be tilled outby
wo copies of separate drawing Indicate North Town of,$outh Windsor
No. cuts
Est. Patch Size(s) sl
Est. Pvt. Thickness in.
Est. Patch Unit Price$ isl
0
\g Est, Patch Cost$
4t-, Est. Curb Replacement It
Est, Curb Unit Price$ /It
.d�wz+tjC Est. Curb Cost$
—� Est. Traffic Unit Cost$ rhr
Est. Traffic Control $
Amt. of Deposit $
Total Due $
( )Cash ( )Check#
i Applicant is responsible for contacting Paid By
!ne 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
PERM[ UTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT.PERMIT MANUAL,
Sjgned
T.tie GL����� 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
Sweet Excavation Permit 08 REV 10.22.08