HomeMy WebLinkAboutStreet Cut Permits 72 Brook Street (2) 1300223 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/26/2013 =
GIS ID: 14400072 = FEE: 25.00
MUNIS APPLICATION# 201301215 =� EXPIRATION DATE: 08/26/2014
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APPLICANT = ;ice, LOCATION
NAME: QUALITY PAVING CO I DRES 72 BROQK STREET
ADDRESS: 194 S.MAIN STREET
OSIER SKIL,TON-- LINDA R
EAST WINDSOR,CT�6 8 „ � ft&STREET
WINDSOR,CT 06074
PHONE 860-523-4182
WORK DESCRIPTION: DRIVEAM, Y AF
APPLICANT AGREES TO FURNISH THEWOESOUT1$ ��AMOFI ( QND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANC EAWEN'S$ dN U�D I I E OWN 1fl�2 IAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND T16 LI• A'NT IS FA1 I WICF AN W L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN 01` 0 TRECT PE13NfIT MANUAL.
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ISSUED BY DATEINECTED INSPECTED BY
8/26/2013 11:57 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 13 40 Qa 3 CONTRACTOR:
LOCATION: 7ol Pirook sy-ree,y'
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: 2
INSPECTED BY:
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:_
W12007 Town of South Windsor INPSECTION REPORT 07
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 $26.00
Name of Firm Phone No,
Address of Firm Zip Code,
Location of.proposed w,ofk
Describe fully nature of permif rogue;:odej
Sta ing date $ Approx.time for completion 4 !a
Call Before You Dig No. Existing Water Supply: [I Public ater C]Welt
Existing:Sewage Service: , . ❑PubticSewer [a Septic
PLEASE NOTE: THE.DEPOSIT.FORTHE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT S 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 TOW N'$CONTRACT COSTS. THE PERMANENT.PATCN:,ISI TYPICALLY
COMPLETED WITHIN A YEAR'OF THE TEMPORARY PATCH BUT IT COULD.BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
r ' t Est.Pvt.Thickness in.
i I 0 I Est.Patch Unit Price$ lsf
Est.Patch Cost$
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Est.Curb Replacement ft
t
Est.Curb Unit Price$ /ft
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Est.Curb Cost,$
Est.Traffic Unit Cost$ 1hr
Est.Traffic Control:$
V t j Amt.of Deposit$
Total Due$
(,)Cash O Check#
Applicant is responsible forcontacting Paid By
the Police.De t.and C.13.Y.D
I AGREE TO'FU13NISH 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 UTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL,
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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 Mr.Donald D'Avanzo
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES 192 Carriage Dr.
Manchester,CT 06040-6650
Street Excsvatin Permit 08 REV 10 22-08 .