HomeMy WebLinkAboutStreet Cut Permits 261 Skyline Drive (2) 1300187 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/18/2013
GIS ID: 83100261 FEE: 25.00
MUNIS APPLICATION# 201300994 - 1 E £PIRATION DATE: 07/18/2014
APPLICANTY I'lAf It , LOCATION
NAME: ADVANCED CONSTR JCTIO I DDRES�_ f ,INE DRIVE
ADDRESS: 5 CHESTNUT HILL ROA-I� ERA RNA PLOPERTIES LLC
STAFFORD,CT 0607 ' 67 BA'NCI�OFT LANE
% 7tJTI ' INDSOR,CT 06074
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PHONE 860-519-8442 fy
WORK DESCRIPTION: INSTALk-IMA�ACE C V
APPLICANT AGREES TO FURNISH THE TpVVl?I�?I SOUTHI# 3E RM03NT CIF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN f'EXPENSES INCtfiIJ s �x1 Td WN FAR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THI I IcAm`LJS AI M WIT31 ANI3 WI ,ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OPS0--ft TREI T-.CI33'PER f T MANUAL.
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ISSUED BY DATE INSPECTED INSPECTED BY
7/18/2013 8:07 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
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PERMIT NO.:_ — _ - CONTRACTOR: !Q dVA+1C,
LOCATION: �rsl
TYPE OF WORK: 0 5iia .g
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: e-b
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C JAA_ DATE:_���1
W/2007 Town of South Windsor INPSECTION REPORT 07
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 j .e Phone No.
Address of Firm I eh eSf rbY7 $ r Zip Code f,Aey
Location of proposed work
Desce fully nature of permit requested
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Starting date Approx.time for completion
Call Before You Dig No. 12-�LQ,? 2 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 fumish This sebtion to be filled out by
two copies of separate drawing indicate North Town of South Windsor
No.cuts
Est.Patch Sizes) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ !sf
Est.Patch Cost S
Est.Curb Replacement ft
Est.Curb Unit Price-$.. /it
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control
Amt.of Deposit$
Total Due S
{ )Cash O Check#
Applicant is responsible for contacting Paid By
the Police , t.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 WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNEC WI THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMIT AS O INEDIN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMITUAL.
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