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HomeMy WebLinkAboutStreet Cut Permits 48 Dawn Drive (2) 1300185 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 07/17/2013 GIS ID: 26400048 `% FEE: 25.00 MUNIS APPLICATION# 201300990 - iPIRATION DATE: 07/17/2014 MRS APPLICANT- = �„ LOCATION NAME: ADVANCED CONSTRfCTION DRESS 48 DAWN DRIVE ADDRESS: 5 CHESTNUT HILL R&O �� 1ER� = I�{}SS DAVID&LAURA STAFFORD,CT 0607 48A DRIVE I IN _ U I H V NDSOR,CT 06074 PHONE 860-519-8442 J_ - i WORK DESCRIPTION: INSTALo CA APPLICANT AGREES TO FURNISH THE T'_ _ P jOU H }��I E AMOUI I CIF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR AN I E�ISESINC PJ-_-_}�3%fH T VN FOR 1 AINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THEPIAI�QS 1tATv1IA1R�WIT-I ANQ WII ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OA k H II TI SR'S T-REED-CUT PI RI 1T MANUAL. ISSUED BY DAM INS ED INSPECTED BY 7/17/20139:48AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** Ast ff �� i = i „ 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 $25.00 Name of Firm_ F,.�c,I nP r ri Phone No. Address of FirmCh c;•+,3,9-ac �(g a�nCt < rT Zip Code Location of proposed worker �� wa,fl f� , Describe fully nature of permit requested Starting date C? Approx.time for completion Call Before You Dig No. Existing Water Supply: ❑Public Water ❑well Existing Sewage Service: ❑ Public Sewer ❑Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch of proposed work or furnish ---two copies of separate drawing This section to be filled out by Indicate North Town of SouL Windsor No. cuts 0 Est. Patch Size(s) sf Est. Pvt.Thickness Est. Patch Unit Price$ /sf Est.Patch Cost Est. Curb Replacement '_j Est. Curb Unit Price$—_________/ft Est.Curb Cost$ Est. Traffic Unit Cost$........ _/hr Est.Traffic Control$_ Amt.of Deposit$ Total Due$ ( )Cash ( )Check# Applicant is responsible for contacting Paid B the Police De t.and C.B.Y.D. y 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 PERMITAND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: Date:�� 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 TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: Q® J CONTRACTOR: dL9 C�� of aye c_ 7K/V^ LOCATION: TYPE OF WORK: DATE INSP NEEDED: DATE INSP: f-6 -�Y INSPECTED BY: (3b WORK IN PROGRESS: s ,, SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: C DATE: a i W/2007 Town of South Windsor INPSECTION REPORT 07