HomeMy WebLinkAboutStreet Cut Permits 170 Orchard Hill Driv (2) 1300071 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 04/30/2013
GIS ID: 66900170 FEE:
MUNIS APPLICATION# 201300531 25.00
LPIRATION DATE: 04/30/2014
APPLICANT' %
LOCATION
NAME: AIROLDI'S INC.
RES-& ( RIARD HILL DRIVE
ADDRESS: P O BOX 71 %/ E �_ 1ZZAO VINCENT J&DEBORAH D
SOUTH WINDSOR,CT 074 - I7d OftkARD HILL DR
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PHONE w %% % Vr DSOR,CT 06074
WORK DESCRIPTION: DRIV W�1? �
APPLICANT AGREES TO FURNISH THE rQWv0 o" _� A1G� Q B( ID REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANC F E REQUIRED
OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THI AP0Lj�AjZ,1 WI -,V WIA ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OOIIII3IPRI MANUAL.
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ISSUED BY
DAB QED SPECTED BY
4/30/2013 11:56 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO..-_Z3 OW7 CONTRACTOR: 41 V o al/ I's
LOCATION:
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TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BYE
WORK IN
PROGRESS:_ ,1-05 t'D 2, Work -T' .
�,���te. ,o f- •per,.�.e �� y
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
PUBLIC WORKS DEPARTMENT Permit No,
1540 SULLIVAN AVENUE Date; 4 6 \3
SOUTH WINDSOR, CT 06074
_ FEE $25.00
Name of Firm e�C� S \,cv c. . 6�
Phone No. \fig`'1 `--�'B`1 �
Address of Firm
Zip Code_
Location of proposed work \7\IF, €����c�v3� \�•\\ �,
Describe fully nature of permit requested_
Staning dale_ y3 Approx, time for completion -
Call Before You Dig No, Existing Water Supply; ❑ Public Water ❑ Well
Existing Sewage Service; ❑ Public Sewer ❑ Septic
PRELIMINARY ESTIMATE, THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT I COST OF THE
S A
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS, THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish
two copies of separate drawing FNo.
is section to f2e tilled out by
i
Indicate NorthTown of South Windso0r
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uts
Est. Patch Size(s) si
I
Est, Pvt, Thickness in.
c" Est. Patch Unit Price$ /si
Est. Patch Cost$
Est. Curb Replacement It
Est. Curb Unit Price$_lit
Est. Curb Cost$
Est. Traffic Unit Cost$ /hr
Est. Traffic Control $
Amt. of Deposit$
Total Due $
i
( ) Cash ( )Check#
Applicant is responsible for contacting Paid By
I 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
PERMI UTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Dale:
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 10.22.08