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HomeMy WebLinkAboutStreet Cut Permits 196 Beelzebub Road (2) 1300295 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 11/20/2013 GIS ID: 09000196 FEE: 0.00 MUNIS APPLICATION# 201301732 - _ = ,EXPIRATION DATE: APPLICANT % LOCATION NAME: YANKEE GAS = DD3SS. I96 BLZEBUB ROAD ADDRESS: 112 PROSPECT HILL RD OWNER 1 dV1ICI ERIC A EAST WINDSOR,CT P60M 196,BEE ZEBUB ROAD SOUIPI WINDSOR,CT 06074 PHONE 860-292-2242on - = WORK DESCRIPTION: YANKSR WIISAL GAS SEIUICL:FROM MAIN IN ROAD i APPLICANT AGREES TO FURNISH THE VOWN QF D T II+I1? pI TE AMOUNT OF TON REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR AY ECPENSES T1�ICUREYHI TOWIFOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND AflOP,LICANT I FAMII TA WITH AND WILL=ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN*SOUTH WINDSR S E.I. `UTPI RML MANUAL. ISSUED BY "DATE INSPECTED` INSPECTED BY 11/20/2013 1:15 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** ff 45 off TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: 1 3 00 �P_1,5 CONTRACTOR: LOCATION:_ TYPE OF WORK:_ G4 5 DATE INSP NEEDED: DATE INSP: INSPECTED BY: aD WORK IN PROGRESS: SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: tt'/2 1 13' :7i uth Windsor NIPSECTION REPORT 07 11/07./2013 ;THU 12t 21 FAX 860 292 2202 I�100'6/40b , 3 O ' 7 I�A P a l 3 LtCATtflN FGR STREET EXCAVATION PERMIT 0 Appl. TOVYN OF. OUTH 3fVtNDSaR / PUBLIC.WORKS UEPART1I+IENT Permit Na t540 SULLIVAN AVENUE Date. /l SOUTH WINDSOft CT 06074 J�-00 FEE 2 Name of Finn 1:w n ►.� Phone No: . Address of Frm Cw u Zip Cade Location b, proposed'work— l ' ©esoribe fully,nature of permit requestedjca � 9t� S7 -moo Starting date_ Approx.time.for co Call Before You Dig No.Ac21 E..xistirr Water Su I : — 9 PP IT {]Public;Water 1]Well Existing Sewage service: ❑Public Sewer Septic -PLEASE NOTE..THE DEPOSIT FOR THE PEI'llRMANENT;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,JNCL.UDINS ANY tNCREi4SES IN PATCH AREA, CURB L-�ENGRiiTAAFFiGfiONTR®L-ANB-?'d-lE-tpWN'S�GON `A-ACT-EC}ST : THE PERMANENI PY4TGM IS TY iGALL I C43MPLETI;D WITHIWA YEAR OF THE TEMPORAkY PATCH$t1T IT COULD BE LATER THAN A YEAR. Shaw sketch of proposed work or fumish two copies of separate drawing This section to be filled out by lndieate North Town of South Windsor �q . No.cuts Est.Patch Sizes) Est.Pvt. Thickness Est.Patch Unit Price fEst.Patch Cost Est.Curb Replacement ft n Est.Curb Unit Price$ Est.Curb Cost$ Est.Traffic Unit Cost$ /hr a�►X ► Est.Traffic Control$ Amt.of Deposit$ i ��Sf• 'total Due$ bec_IZEDtcD h..ct )Cash f )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 A131DE BY THE RULES AND REGULATIONS FpR PERMITS AS OUTLINED IN HE ��W,�N OF SOUTH W INDSOR'S STREET CUT PE PIT ANUAL. Signed: o rG�. Date: Title: Drivers license#: PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT WORK MAY NOT BEGIN UNTIL A PERMIT HAS 13EEN ISSUED PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Street Excavation Permit 08 REV 10-22-08