HomeMy WebLinkAboutStreet Cut Permits 36 Oxford Drive (2) 1300182 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/17/2013 ,
GIS ID: 68100036 FEE: 25.00
MUNIS APPLICATION# 201300987 EXPIRATION DATE: 07/17/2014
APPLICom
ANT, - - i
LOCATION
NAME: ADVANCED CONSTROCTION ADDRESS 36 O FO D DRIVE
ADDRESS: 5 CHESTNUT HILL ROAR E S J MES
STAFFORD,CT 0607d = l OEO$D DRIVE
1 H WINDSOR, CT 06074
PHONE 860-519-8442 - -
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WORK DESCRIPTION: INSTAII;PI� E
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APPLICANT AGREES TO FURNISH THE TQW �JF OUTLI V JI3SQI i NIO VN OF BQ 1D REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY 'EIVSE IN $MIME TO 114 I OR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THl P L ALIT IS FANTIEIAI WISH AIxII}W1J� ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OA J i H? jf kbSRX TRJEVf CU"1`PER t11 MANUAL.
ISSUED BY DATtT gSPECTED INSPECTED BY
7/17/2013 9:38 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:_jZ 00 1a- CONTRACTOR: jfl6Q(ed Cd1_5iZ .
LOCATION: tea
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: —6 -1 St
INSPECTED BY: 3�
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: L DATE:
W/2007 Town of South Windsor INPSECfION 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 $25.00
Name of Firm Gy� 1r rr1t r t C",�►1 n Q I'Aec QA4 Sell Phone No. D
Address of Firm Ch r—SI:4 r-i t- h:k\ f 26�. • LSP-a Y—tom r�1�c0T' Zip Code
Location of proposed work_ n'X
Describe fully nature of permit requested_ 1 n e-6 (I /YP to I ca.rP
0
Starting date Approx. time for completion
Call Before You Dig No. tiA Existing Water Supply: ❑ P b c Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No. cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est.Patch Cost
d 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
( )Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police Dept.and C.B.Y.0.
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
PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT NUAL.
Signed: V 71 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