HomeMy WebLinkAboutStreet Cut Permits 103 Homestead Drive (2) 1300095 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER _ _ - STREET CUT PERMIT
DATE: 05/15/2013 _
GIS ID:44700103 FEE: 25.00
MUNIS APPLICATION# 201300621
s -XPIRATION DATE: 05/15/2014
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APPLICANT LOCATION
NAME: ADVANCED CONSTLIG I(N DRE53I0IESTEAD DRIVE
ADDRESS: 5 CHESTNUT HILL� % Eg. S BARBARA K
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STAFFORD,CT 060711 ONIESTEAD DR
�INDSOR,CT 060742214
PHONE 860-519-8442
WORK DESCRIPTION: INSAAmp;P��U,E C� �UK
APPLICANT AGREES TO FURNISH THE 1VOFOUTITCAMQCTBND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANS3I IAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TH> �1I�P GAN�j$ IAT� I A W L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS O�U�TLINED IN THE TOWN OF T I W31a1IS S-- VT P IT MANUAL.
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ISSUED Y D A T- C T E D INSPECTED BY
5/15/2013 11;14 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT N0.:__13 pZ►O as" CONTRACTOR: Conn`tY'.
LOCATION: Q
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: I2- l3
INSPECTED BY;
WORK ITV-
PROGRESS: ,
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:____�� _
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
, $25.00
Name of Firm A0yO1��L�0 ( Ci1�I. ��C�lt1C�`��V`1� `�( Phone No.SL0 1_)
Address of Firm `_S ( 1A-P— ((Vv\ �OG�C 70�2 Zip Code b _
Location of proposed work c
Describe fully nature of permit requested U^ S tC� /�-TV
Starting date = Approx. time for completion
Call Before You Dig No, ;i1 Existing Water Supply: ❑ Public Water ❑ Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No. cuts
Est. Patch Size(s) sf
Est. Pvt. Thickness in.
Est. Patch Unit Price$ /sf
Est. Patch Cost$
Est. Curb Replacement ft
Est. Curb Unit Price
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 W IS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS TLINE IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.lf
Signed: Date: T�
Title: Driver's License it:
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