HomeMy WebLinkAboutStreet Cut Permits 145 Farmstead Drive (2) 1300068 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 04/23/2013
GIS ID: 31800145 FEE: 25.00
SRI
MUNIS APPLICATION# 201300502 -0
= EXPIRATION DATE: 04/23/2014
APPLICANT - CATION
NAME: QUALITY PAVING CO AL / -ADRES f4FAftMSTEAD DRIVE
ADDRESS: 194 S. MAIN STREET EI WTI K�NON JOHN J C& SUSAN A
EAST WINDSOR,CT�- 0_0 -- 14 FARMSTEAD DRIVE
- j� AS((3 WINDSOR,CT 06074
PHONE 860-523-4182of
j
WORK DESCRIPTION: DRILY
APPLICANT AGREES TO FURNISH THE 1W��1~ QUT �11MQT( BAND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THIPPLAA7S IAA WL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OPiITI W15I:"SSIff PIIITPEIIT MANUAL.
1169
ISSUED BY DATEINSP CTED INSPECTED BY
4/23/2013 3:38 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: ��D 66) CONTRACTOR:
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: aD
WORK IN
PROGRESS:�� GCe L
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:-
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR STREET EXCAVATION PERMIT
-App.I.No. L�ESO INDSQR Permit No,
PUBLIC WORDS DEPARTMENT -
1540 SULUVAN AVENUE Date: Z3
SOUTH WINDSOR,;CT 06074
PEE $2500
Name o. Firm Phone o.
Address of Firm` Zip Code
Location of proposed work
Describe fully,nature.of.permit requested
r
Starring date 2b I Approxtime for comp) tion '
Cali Before.You: N4: D' . Existing;Water Supply: 0 Public Water ❑Well
Existing Sewage Service: {I Public Sewer Septrc
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT:PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMLIVARY ESTIMATE. THE APPLICANT IS RESPONSIBL€"FORIHE FULL FM CAST OF THE
PERMANENT PATCH AND-CURB REPLACEMENT;INCLUDING ANY INCREASES IN PATCH AREA,CURB..
i<,ENGTH TRAFFIC;GONTROL�AND;THE TOWN'S CONTRACT:COSTS.. THE•PI=RMANENT PATCH IS TYPICALLY
COMPLETED WITHINAYEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER.THAN A YEAR.
Show sketch of proposed work or furnish This sect m to begged out by
two copies of separate dravuing Indicate.North �n.of'South Windsor ,
a
No.cuts'
i
Est.Patch Sizew sf
Est.Pvt.Thickness in.
0
Est.Patch Unit Price$ isf
S Est.Patch Cost$
+ Est.Curb Replacement It
t \\9 Est.Curb Unit Price$ !lt
Est.Curb Cost
f"
Est..Traffic Unit Cost S
Est:Traffic Control$
- - - Arnt.ofDeposit
Mr.Donald A.D'Avanzo Tota{Due$
� D j 182 Carriage Dr.
�„® Manchester,CT 06040 I. O Cash OCheck#
Applicant is responsible for contacting Paid By
thoftlice-De t,and O.B.Y.D.
I AGREE TO FURNISH TO.THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND Tor REIMBURSE THE
TOWN OF.SOUTH.ININDSOR FOR ANY EXPENSES INCURRED BY,THE TOWN FOR:MAINTENANCE.OR REPAIR WORK IN
COtVNEG�ION:WITH THIS PERMIT AND THAT I.AM FAMILIAR WITH ANp;WILL ABIDE BY THE RULES
.AND REGULATIONS FOR;
PERINITS AS,O�U!l LINED:IN,THEpTOV�N OF SOUTH WINDS STREET CUT PERMIT MANUAL..
Signed: /�111 �- dJ.��rt�" r Date:
Title:, �Q/� C �' Driver's license#:
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS SEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street acavaWn Permit 08 REV 10-22-08