HomeMy WebLinkAboutStreet Cut Permits 36 Judge Lane (2) 1300199 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/30/2013 ,.
GIS ID: 48300036 FEE: 25.00
MUNIS APPLICATION# 201301073 % EPIRATION DATE: 07/30/2014
APPLICANT =C,fLOCATION
NAME: TELE-NETWORKS io
- BREA- 36 JL-D LANE
ADDRESS: 31 BAKEWELL COURk ER` --D MARVNO DARREN J&DEBORAH A
CRASTON,RI 02921 _ JLGl LANE
% SLTI W�NDSOR,CT 06074
PHONE 401-461-8420
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WORK DESCRIPTION: REPLAEXIIG '
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APPLICANT AGREES TO FURNISH THE T WISP S6U1 -. I�Molww O00 D REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANPENSISaitR3�ED'13IITII TOWN»R MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE4PKIANTJS RA1 wi NWIL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF UI WII�IIRTREEI CUT.PI R1fT MANUAL.
ISSUED BY DA D INSPECTED BY
7/30/2013 9:08 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 13 0 I q CONTRACTOR: tP.le'
LOCATION: 3 L.G'i
TYPE OF WORK:_ fe pIa(e, C'X1 nG C TU
DATE INSP NEEDED: DATE INSP.-
INSPECTED BY:
WORK IN
PROGRESS:__
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: Lam. DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
f APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: is
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm -12 c-Je400rkS Phone No. 3 o 9
Address of Firm 31 u1e() C4 nr��nc-fin V T_ Zip Code O ct 9-1
Location of proposed work
Describe fully nature of permit requested CA-1 V
Starting date 'S, ;2(. Qo I Approx. time for completion
Call Before You Dig No.,2Q 13 �000 9gs Existing Water Supply: ❑ Public Water ❑ Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
0 No.cuts
Est. Patch Size(s) sf
.30re's Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est. Patch Cost$
Est. Curb Replacement ft
Est. Curb Unit Price$ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
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 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 O I D I HE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: ?b 4-1 12013
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
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