HomeMy WebLinkAboutStreet Cut Permits 44 Oakwood Drive (2) 1300139 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/21/2013
GIS ID: 66000044 MUNIS APPLICATION# 201300854 - / pIRATION DATE:FEE: 06/21 25.00 25.00
/2014
APPLICANTI -
gLOCATION
NAME: AIROLDI'S INC. RES 4 CAK
G � _OOD DRIVE
ADDRESS: P O BOX 71 $ LA��7CkICH DENNIS A&PATRICIA J
SOUTH WINDSOR,GT 7T% �lOAKWOOD DRIVE
PHONE
= JVINDSOR, CT 06074
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WORK DESCRIPTION: DRIVtANq-
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APPLICANT AGREES TO FURNISH THE I W �JF`S61J I4 II :S0����AMO B( VD REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANI E ISENNC IT WN TVR AINTENANCE OR REPAIR WORK IN
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CONNECTION WITH THIS PERMIT AND THI P LI-AAT J��IWW�T AI WW&ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OAOLYfiL�WI3�ISR#sIJ1 pl ITT MANUAL.
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ISSUED BY DATIrINSPtCTED INSPEJCTED BY
6/21/2013 8:41 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1 o013 CONTRACTOR: \f o1.cl 1 -s
LOCATION: �� -k 130od
TYPE OF WORK: . W le jct
DATE INSP NEEDED: DATE INSP: - Xq
r15�
INSPECTED BY
WORK IN
PROGRESS: o
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: W\_ DATE: q _
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR ST EET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date. ` Cl
SOUTH WINDSOR,CT 06074
FEE $25600
M`♦ �r�
Name of Firm Phone No , '' �;�� ',�
Address of Firm �\ Zip Code
Location of proposed work v S
Describe fully nature.of permit request tsak",- n� c � re"\c��s� kaixi
Starting date Approx.time for completion 12
Call Before,You Do No. O Existing Water Supply: d Public Water ❑Well
Existing Sewage Service: 0 Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PREUMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT;INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC>CONTROL AND THE TOWNS CONTRACT COSTS. THE PERMANENT.PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE T&APORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
-Show sketch of proposed work or furnish phis section to be filled out by
two copies of separate drawing Indicate.North T vr�.of S o Windsor
No.cuts
Est.Patch Size(s) sf
w
- Est.Pvt.Thickness in.
Est.Patch Unit Price$ 1sf
1 Est.Patch cost:
s� -
Est.Curb Replacement ft
Est.Curb unit Price$ /It
}•� Est.Curb Costs
Est..Traffic Unit Cost$ fir
Est:Traffic Control$
Amt.of Deposit$
Total Due S
Cash ( )Check#
Applil�bt is responsible for contacting Paid By
the Ponce 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 INDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONN, WI IT AND THAT I AM FAMILIAR WITH.AND WILL ABIDE BY THE RULES;AND REGULATIONS FOR.
PERM AS TOWN OF SOUTH WINDSOR'S STfiEET CUT PERMIT NG4NUAL.
-Sign ' Dater
Driver's License#; LA S
". PLEASS;ALLOW AT LEAST WORKING,DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
•WORK 14,AYNOT BEGIN UNTIL A PERMIT HAS,BEEN I$SUED
-PERMI ;:HALL BE-KEPT ON JOSSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08