HomeMy WebLinkAboutStreet Cut Permits 89 Pheasant Way (2) 1300115 TOWN OF SOUTH WINDSOR,
PERMIT NUMBER C T
STREET CUT PERMIT
DATE: 05/22/2013
GIS ID: 71100089
MUNIS APPLICATION# 201300692 FEE: 25.00
PIRATION DA
TE: 05/22/2014
APPLICANVfg _
NAME: AIROLDI'S INC. LOCATION
ADDRESS: P 0 BOX 71 % �?DRE� V THEASANT WAY
SOUTH WINDSOR, �T�f�04ff E ; GLIKHRISTOPHER&JADWIGA
RANT WAY
PHONE _ ----- UINDSOR,CT 06074
WORK DESCRIPTION:
DRIVEWAY
APPLICANT AGREES TO FURNISH THE 1jVA1 SOUTH
THE TOWN OF SOUTH WINDSOR FOR ANY LXT' I STN1M4T OBND REQUIRED AND TO REIMBURSE
AINTENANCE ORCONNECTION WITH THIS PERMIT AND THIl1I�I' CANTSwkTKIWL�ABIDE BY THE RULES AND REGU IN
LATIONS
FOR PERMITS AS OUTLINED IN THE TOWN 01`4OF'T�Iu� �
UT IxEGIIT MANUAL. NS
ISSUE
DATE `
5/22/2013 2:30 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** INSPECTED BY
of-AN
-iffm
j�j� / =
_
V
��
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /3 00/>5— CONTRACTOR: l�i y-o
LOCATION:—`�J22�P � �Q u
TYPE OF WORK: >
DATE INSP NEEDED: DATE INSP: r -1 K
In)ECTM BY:
WORK IN
PROGRESS:
riJCt � i
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT:. DATE:
42
S/FORMS/TOWN OF SOUM WINDSOR INSPECTION
x'tnat+
�N'y Y �'�L'!�t'G'
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 $25.00
Name of Firm o��� S N C- Phone No,
Address of Firm o r r1 �o>v�\, �'•-y oY Zip Code—06011
Location of proposed work
Describe fully nature of permit requested
Staving dale Approx. time for completion
Call Before You Dig No. '��� `�����'t Existing Water Supply: ❑ Public Water ❑ Well
Existing Sewage Service: ❑ Public Sewer Cl Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Snow sketch of proposed work or furnish This s@ctlpn to be filled out
!wo copies of separate drawing Indicate North Town of South Windsor
No. cuts
Est. Patch Size(s) sf
t — Est. PvL Thickness in.
0
Est, Patch Unit Price$ rsl
Est.Patch Cost$
Est. Curb Replacement ft
Est. Curb Unit Price$ /it
Est. Curb Cost$
Est. Traffic Unit Cost$ ihr
Est. Traffic Control $
Amt. of Deposit $
Total Due$
1 ( ) Cash ( ) Check#
Applicant is responsible for contacting Paid By
the Police Dept. and C.S.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
PERMI UTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed%� DaIe:
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
Saeec Excavation Permit 08 REV 10.22.08