HomeMy WebLinkAboutStreet Cut Permits 9999 Rosemary Lane (3) - --A 300075 __- _ -- - ------ - - - -T-O-W N- Of-S O U T-H-WIN-D-S O R, C T
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/01/2013
GIS ID: 77409999 � � FEE: 0.00
MUNIS APPLICATION# 201300550 A k KPIRATION DATE: 05/01/2014
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APPLICANTS , LOCATION
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NAME: B&W PAVING&LAN&CAPlNG lof !�AI)BkEgk A08 1V1 RY LN FROM ABBE RD EXT
ADDRESS: P 0 BOX 70 E '� �(JWN( SOUTH WINDSOR
MYSTIC, CT 06355 /el54(I-S'UI ,IVAN AVE
y j i,INDSOR, CT 060742734
PHONE 1-860-571-9942
WORK DESCRIPTION: VvER ADJUST
HEIGTFFOR PAVING
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APPLICANT AGREES TO FURNISH THE IQWbf -S . � 0 ( BC ID REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANC EPENE � �� NR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THNAP 1 I A T IS IDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN 0 F%o`IWIN-D P} R T MANUAL.
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ISSUED 13 DAPFTNS-PECTIEID INSPECTED BY
5/1/2013 12:20 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 13 00o Is CONTRACTOR: +-I,.� Piw ihg Lav dscm
pe
LOCATION: R'mtel Win e u L A -Or AA AAe R11 ►-
TYPE OF WORK:
DATE INSP NEEDED; DATE IMP:
INSPECTED BY: Qu
WORK IN
PROGRESS, 8l
SEPTIC TANK PUMPED, SMASHED,FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/FOPMSJTOWN OF SOUTH WINDSOR INSPECTION +
APPUCATION FOR STREET EXCAVATION PERMIT 1,30n0 7 5s
fito- - - TOWN-aPSCUTHWINDSOIt --
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Dafe: Avr so--'old
SOUTH WINDSOR,CT{#Ilf)74
FEE $26.00
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Name of Flan ` C ,0 Phone No,
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Address of Firm - r� , 7p Code ,
Location of proposed W0
Descdbe fully re of p tttt Oemti;
; 7 ,
Startiry darts X50fIK �� -2 d _Appm.Sme for
Call Before You Do No. e 8o t V2 3 EJ(Wng Wad Supply. Q PWAC Water Q We4
E ng Sewage vice. [I Pubk Sewer ❑Sew
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ELATE. THE APPLICANT fS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT;INCLUDING11 ANY CEASES 0 PATCH AREA,CURB
LENGIM TRWM CONTROL AND THE TOWN'S CONTRACT Ct?SM THE'PERMANENT PATCH IS TYPICALLY
CL?MPLETED WITHIN A YEAR OF THE TBuMARy PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or fungsh lh to be .4 L
two dt� kK k;ate.North ,YOM of SouthMndsor
No.cuts
Alva- 0 Est.Patch ems) sf
Est.Pvt.ThIckross in.
Est.Patch Unk Price$ rd
Est,Patch Cost
Est.Curb R nvent_________ft
Est,Qsb Unit Pace S ra
EsL Otab Cost:
Est.Trafttc Unit Cost$ fir
EvL Traffic Control
Amt of Deposit S
Total Due S
( )Cash { }Check 4
Applicant is responsiNe,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 REO UIRED 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 OUTI, ED IN THE TOWN OF SOUTH WINO}SOR'S STREET OUT PERMIT'MANUAL.
Signed: - ,, Gate,
Title; Driver's License#:
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPUCA71ON FOR.ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOSSITE AT ALL TIMES
Street Excavation PertNt 08 REV 20-22-08