HomeMy WebLinkAboutStreet Cut Permits 86 Carson Way (2) 1300092 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 05/15/2013 Ell
GIS ID: 17600086 FEE:
MUNIS APPLICATION# 201300617 25.00
EXPIRATION DATE: 05/15/2014
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APPLICAN`ir '4 LOCATION
NAME: ADVANCED CONSTIUC I01 DRESS- __ON WAY
ADDRESS: 5 CHESTNUT HILL RD Jf STAFFORD, CT 0603 %� % € ER �. IRISTOPHER C&REBECCA A
S` N WAY
Du t INDSOR,CT 06074
PHONE 860-519-8442 /
WORK DESCRIPTION: INSTA APPLICANT AGREES TO FURNISH THE TOVOF SOU OF BAND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANC LPISE INIF �ggAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THEMQ W L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OOiTSItF IEIIT MANUAL.
ISSUED BY DATE MmcTED INSPECTED BY
5/15/2013 10:58 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /3 000 Vol
CONTRACTOR: A Va YV ed c o OS ire.
LOCATION:
TYPE OF WORK: v
DATE INSP NEEDED: DATE IIVSP: Cz - 3
INSPECTED BY: 6b
WORK IN
PROGRESS: (�P f�,"54 Iry
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT:— G DATE:
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR_STREET EXCAVATION PERMIT— — — —
Appl, No. TOWN OF SOUTH WINDSOR `iPermit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR, CT 06074
FEE $25.00 CC nn
Name of Firm A J �r�\Lela �UI>>, ��C��W(�OG `3,C• Phone No.SSLO
Address of Firm cS I -e-5�' y T �O LL 1260 rj ROO-) r Zip CodecL—
Location of proposed work p Vl V"
Describe fully nature of permit requested
Starting date S _ ,Approx. time for completion / "D
Call Before You Dig No. 0 ®-7 Existing Water Supply: ❑ Public Water ❑ Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No. cuts
Est. Patch Size(s)_ .__ __sf
Est. Pvt. Thickness _in.
0
Est. Patch Unit Price
Est, Patch Cost$
Est. Curb Replacement ft
Est. Curb Unit Price
Est. Curb Cost$__
Est. Traffic Unit Cost$ /hr
r5 D Est.Traffic Control $
e
` Amt. of Deposit$_
Total Due$
( ) Cash
Applicant is responsible for contacting Paid
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 AAS �NED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: _ — Date: 5/I
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