HomeMy WebLinkAboutStreet Cut Permits 78 Carson Way (2) 1300118 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/29/2013
GIS ID: 17600078 FEE: 25.00
MUNIS APPLICATION# 201300715 — PIRATION DATE: 05/29/2014
ii Ai
i� AN
APPLICANT - �'
-� LOCATION
NAME: ADVANCED CONS ION ,1 DRE '-t ON WAY
ADDRESS: 5 CHESTNUT HILL ;DELU NICOLA&LINDA
STAFFORD,CT 0607�
r�
B CARS)N WAY
qw UU INDSOR,CT 06074
PHONE 860-519-8442
WORK DESCRIPTION: INSTA RBP 1 C �A�El LIN� �
00;-
APPLICANT AGREES TO FURNISH THE E SQUT �1"AMOM—OMB iD REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANC R 'FNE Imom TI�IRIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THIIAI flLCANTS I W W L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OP, TVI, R3 ��T PENT MANUAL.
ISSUED BY DAT ' CTED INSPECTED BY
5/29/2013 11:58 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
AW-
ff - i
% j
OF
i i%
/
i
w
-% I: i �,
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:_ l3oO 11 CONTRACTOR: AaJgrn eA Com'Af
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: i .b
INSPECTED BY: c,yx
WORK IN
PROGRESS: o►�- c e. ova r
SEPTIC TANK PUMPED, SMASHED,FILLED WITNESSED ❑ YES ❑ NO
AS—BUILT:
INPUT: Lam- DATE:
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR STREET EXCAVATION PERMIT
Appi.No. TOWN OF SOUTH WINDSOR Permit No.
"1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Rm V;�n �/i oi'o �- rn c.In-e-*r mj Serer-Phone No.6c gg45.
Address of Firm 4 �.�1� S't' l' (14t: ha1N —S "3P. r, (� ti Zip Code
Location of proposed work_ :j Q ClAr��QQ_ VY-01
.
Describe fully nature of permit requested_ n fI COK cabl
Starting date^2 y 9 n12,
Approx.time for completion Ti f`�
Call Before You Dig No. Z.,r fa.,, s Existing Water.Supply Public Water ❑Well
} yJ � lug
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 PULL FINAL COST OF THE
s PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH;TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH 1S TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing Indicate.North Towq of South Windsor
` No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness - in.
Est.Patch Unit Price; Isf
7�E Est.Patch Cost;
Est.Curb Replacement ft
Est.Curb Unit Price_;. /ft
Est.Curb Cost;
Est.Traffic Unit Cost; fir
a r S Est.Traffic Control;
Amt.of Deposit;
Total Due;
( )Cash ( )`Check#
• Applicant is responsible for contacting ' Paid B
the Police t.and C.B.Y.D. Y
.
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
TOWN OF SOU OR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECT ITH THIS ERMIT AND THAT 1 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS O TLINED IN E TOWN OF SOUTH WINDSOR'S STREET CUT PER MANUAL.
Signed: Date: 2
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
Street Excavation Permit 08 REV 30-22-08