HomeMy WebLinkAboutStreet Cut Permits 103 Benedict Drive (2) —------___....._.__ -.--
1300145 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/25/2013 „ "
GIS ID: 09600103 / FEE: 25.00
AMR
MUNIS APPLICATION# 201300870 I PIRATION DATE: 06/25/2014
AN
APPLICANTVMS
LOCATION
NAME: AIROLDI'S INC. DARES& IW3 BEXEDICT DRIVE
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ADDRESS: P O BOX 71 ! R B%DNAACZYK BRIAN&LYNN
SOUTH WINDSOR,CTU4 i0740NIyDICT DRIVE
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>JV INDSOR,CT 06074
PHONE IL
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WORK DESCRIPTION: DRIawl-VV - ,
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APPLICANT AGREES TO FURNISH THE IOW�ks6UT1 � REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANPIjN ��R MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE`�A-IUS IA HAN W L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OMw- ftyrw-WINfSw—��R L TpE13 fIT MANUAL.
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ISSUED B DATA TED INSPECTED BY
6/25/2013 11:04 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /3 Qo 1
CONTRACTOR: l
LOCATION: c f VP
TYPE OF WORK: C l �pe wa
DATE INSP NEEDED; DATE INSP.-
WORK IN
PROGRESS:
No S
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: 0
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
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 $25400
Name of Fimt \`cO \� Phone N fi"N649
Address of FirmL Zip Code
Location of proposed work U
D cribe full nature of permit reque &t&A XJ 0
Starting date Approx.time for completion
Call Before.You Dig No: aZZaSIMI►T . Existing Water Supply: J Public-Water ❑Well
Existing Sewage Service: 53Publiic Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
.PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH ANO CURB REPLACEMENT;INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWIVS CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show Sketch of proposed work or famish This section to be MW out by
two copies of separate drawing Indicate.North 1M.of South Windsor
No.cuts
Est.Patch Sizes) sf
"' .. .. •. ` `, Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
T`U1w� Est.Patch Cost
Est.Curb Replacement ft
Est.Curb Unit Price$ fit
Est.Curb Cost;
J Est..Traffic Unit Cost$ Att
Est:Traffic Control s
i Amt.of Deposit$
Total Due$
)Cash ( )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 SO WINDSOR FOR ANY EXPENSES INCURRED 13Y THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNE ON 1 IS PER AND THAT<I AM FAMILIAR WITH ANR WILT.ABIDE BY THE.RULES AND REGULATIONS FOR. ,
PERMS I E TOWN OF SOUTH WINDSOWS STREET CUT PERMIT MANUAL.
Sign Date-�V
Title: Driver's Driver's License#C-Tl384S
PLEASE A. W 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