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HomeMy WebLinkAboutStreet Cut Permits 285 Deming Street (2) 1300096 - TOWN- OF- SOUTH WIND-SOR;_CT PERMIT NUMBER STREET CUT PERMIT DATE: 05/15/2013 Vml A, GIS ID:27600285 =sk FEE: 25.00 MUNIS APPLICATION# 201300623 EXPIRATION DATE: 05/15/2014 of Al— ff A-0/ APPLICANT - LOCATION NAME: ADVANCED CONSTIJ. /q I DRES` 18- EMING STREET ADDRESS: 5 CHESTNUT HILL 1 %ATE / V ; WYSOCI HELEN D L/U&JOSEPH J STAFFORD,CT 060 Ti _40 NG ST PHONE 860-519-8442 i =�U-0 INDSOR,CT 06074 I %i% ime i j// WORK DESCRIPTION: INS I�ALRE C � �� APPLICANT AGREES TO FURNISH THE YW �1iSQUTH�9E AMOK T ? BND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANY R vsp&-Ixk li Q OR fIAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND TH��LCAI�1T TSIAt A WEL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OI &6- I 1 VINDSI' T CST PENT MANUAL. ISSUED DATECTED INSPECTED BY 5/15/2013 11:59 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** - ............... ................ 14100 AV ff . ; i w MOP /ii- // j i ,/ % i / j% /, TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: CONTRACTOR: Cp rs 1r- LOCATION: a 85 De m�%Mel TYPE OF WORK:__ DATE INSP NEEDED: DATE": INSPECTED WORK IN SEPTIC TANK PUMPED, SMASHED, FILLED_WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE:_a. , IP IPI S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION --- - -- -- - -- --A P P LIL T!M FOR-STRE T EXGAV TfO N, -P-E R M T--- -- - - Appl. No. TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT 1540 SULLIVAN AVENUE Date: SOUTH WINDSOR, CT 06074 FE�E,r,$25.00 C n Name of Firm A Q V A -e- ;tt.0 Coy EnG`�1CC,(U\G� Phone No. )A �� Z Address of Firm `S ( IA-P- )�i`�V\ RW- Zip Code b <` Location of proposed work S n► r "- Describe fully nature of permit requested 1V I `cP �L CA C-P— C JJ�TU Starting date Approx. time for completion A 2-'© Call Before You Dig No. �Z_i_�il 15 Existing Water Supply: El Public Water ❑ Well �%�-i- Existing Sewage Service: ❑ Public Sewer ❑ Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch of proposed work or furnish This section to be filled out by two copies of separate drawing Indicate North Town of South Windsor No.cuts 0 Est. Patch Sizes) sf Est. Pvt. Thickness in. Est. Patch Unit Price$ /sf Est. Patch Cost$ Est. Curb Replacement It Est. Curb Unit Price$ /ft 3309 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 OPOUTLI INDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTHIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITSED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: Date: 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