HomeMy WebLinkAboutStreet Cut Permits 66 Good Hill Road (2) 1300298 TOWN OF SOUTH WIND
PERMIT NUMBER S O R, C T
STREET CUT PERMIT
DATE: 11/22/2013
GIS ID:36000066 -
MUNIS APPLICATION# 201301742 - - ; FEE: 25.00
EXPIRATION DATE: 11/22/2014
APPLICANT -
NAME: ADVANCED CONSTRUCTION LOC-CATION
ADDRESS: 5 CHESTNUT HILL R 5 'ADDI S 66 90D HILL ROAD
STAFFORD, CT 06076
OWNER VAUTCrJR ALICE L&COLIN S
66 QQOD HILL ROAD
PHONE 860-519-8442 - SJITII 4INDSOR, CT 06074
WORK DESCRIPTION: INSrALL-UNDL GR CATV� MICR
I APPLICANT AGREES TO FURNISH THE TOWN OF 82�U'I'I�WI7�D��3I�T1�E AMOU�I3'OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AIRY R 'El<ISESDBHE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THIS AP�'LICANT IS I���I��rLT�ANDABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH VC�INDSR S STRE> TU1`I' RMFT MANUAL.
1 f.y
ISSUED BY DATE INSPECTED
INSPECTED BY
11/22/2013 1:59 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /:3co.;9 8 CONTRACTOR: 4 7*>Ll«Kced
LOCATION: 6 6
TYPE OF WORK: C� 47`V
DATE INSP NEEDED: DATE INSP: /
INSPECTED BY: IS b
WORK IN fL
PROGRESS: �' X)Gi I1 t ��. G ,<>., r, c•1 0 1T t � T V
6 8 1 it
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES [:] NO
AS-BUILT:
INPUT: c wt _ DATE:_
W12007 Town of South Windsor INPSECTION REPORT 07
'z-9A,.-?,0174- APPLICATION FOR STREET EXCAVATION PERMIT 1300'z96
Appl. No, TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:__2i ,Z tj
SOUTH WINDSOR,CT 06074 �'—
FEE $25.00
Name of Firm a Gy� �:t.i r F�1 (",,r1 n G 1 ACC- nAA Sell Phone No. '�-Cjz/n
Address of Firm S tiC Zip Code
Location of proposed work
Describe fully nature of permit requested CA V
Starting date_ If I Approx. time for completion k .-,)
Call Before You Dig No. - �> Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish
two copies of separate drawing This section to be filled out by
Indicate North Town of South Windsor
No. cuts__._ _
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
�1
Est. Patch Unit Price$ /sf
Est. Patch Cost$_.
Est. Curb Replacement ft
Est. Curb Unit Price
Est.Curb Cost$
Est.Traffic Unit Cost$
Est.Traffic Control$
Amt.of Deposit$
Total Due
( )Cash ( )Check#
Applicant is responsible for contacting Paid B
the Police Dept.and C.B.Y.D. Y
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:_
Title: 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