HomeMy WebLinkAboutStreet Cut Permits 32 Perrin Lane (2) 1300100 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/15/2013
GIS ID: 70900032 = FEE:
MUNIS APPLICATION# 201300632 25.00
EXPIRATION DATE:
� EX TE: OS/15/2014
APPLICANT
/ -% LOCATION
NAME: AIROLDI'S INC. imam �REI RIN LANE
ADDRESS: P O BOX 71
B�SSIEIATHAN&ALISON
SOUTH WINDSOR,(IfT04
�2Rty LA
PHONE L) WINDSOR,CT V—s-,
06074
-
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WORK DESCRIPTION: DRIVEY
APPLICANT AGREES TO FURNISH THE TmW�I SbUTI � � 4} F pBND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN EXPUN SIN FOR 'gINTENANCE OR REPAIR WORK IN
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CONNECTION WITH THIS PERMIT AND TAW*LCAJSIA �4 WL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OI` OL T�WINf SRs T - F,T; T PE fIT MANUAL.
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ISSUED BY DAT 'IIPJCTED INSPECTED BY
5/15/2013 2:07 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: :300 lot) CONTRACTOR: 1d) ,-s
LOCATION:_ a Pe c ► u
op
TYPE of WowC
DATE INSP NEEDED: DATE INSP: 1-3 ;/
BY:
WORK IN
PROGRESS: ,
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT.
INPUT: l �' _ DATE: z
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
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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 •��o � S ��'� • Phone No. � �—$173\ `3153�
Address of Firm �-o r r1 o��\, �' •� �Y �- Zip Code <Z::)6c39
Location of proposed worker
Describe fully nature of permit requested
Staning dale Approx. time for completion
Ca!i Before You Dig No. `�'s�3\�� \ Existing Water Supply: ❑ Public Water ❑ Well
Existing Sewage Service: ❑ Public Sewer [] Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH, TRAFFIC CONTROL AND THE TOWWS CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Snow sketch of proposed work or furnish This sgctlpn to be tilled out by
!wo copies of separate drawing Indicate North Town of §puth Windsor
No.cuts
i-1 Est. Patch Size(s) st
Est. Pvt. Thickness in.
Est. Patch Unit Price$ /sl
3�f Est. Patch Cost $
Est. Curb Replacement ft
Est. Curb Unit Price$ /it
Est. Curb Cost$
• --'a' 1 Est. Traffic Unit Cost$ /hr
r7i —3
Est.Traffic Control $
Amt. of Deposit $
Total Due $
( )Cash O Check#
j Applicant is responsible for contacting Paid By
the Police Dept. and C.B.Y.D.
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
PERMIINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed Dale: S C. \
Tile G� `��5'�� 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