HomeMy WebLinkAboutStreet Cut Permits 66 Sharon Drive (2) 1300256 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 10/04/2013 '
GIS ID: 82500066 i = FEE: 25.00
MUNIS APPLICATION# 201301445 — i
PIRATION DATE: 10/04/2014
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APPLICAN
�I , LOCATION
NAME: ADVANCED CONSTRJC4 RES 6IAI-0N DRIVE
S
ADDRESS: 5 CHESTNUT HILL R � L S E SUSAN ANN
STAFFORD,CT 0607 _
'�A SHHAR)N DRIVE
� JVINDSOR,CT 06074
PHONE 860-519-8442
WORK DESCRIPTION: INSTAL-1 Mm-A�A �
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APPLICANT AGREES TO FURNISH THE T`QW I��0, TII _ "t Mp i�I BAD REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANISS IAI I ¢ N�jRAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TH , IPP 1NI 4� IA A W L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN 01`1 3, D 4' IT MANUAL.
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ISSUED BY DATJ CTED INSP TED BY
10/4/2013 10:48 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR:Alk t,4 flY�S tR
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP
INSPECTED BY:
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C ._" DATE:
W12007 To:a,n or South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No, TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT Permit No.
1540 SULLIVAN AVENUE Date: �3
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm r✓ '- - c
Phone No. R 6) Af--1-//n
Address of Firm Zip Code
Location of proposed worts
Describe fully nature of permit requested
Starting date Approx. time for completion
Call Before You Dig No. 2�,(`L. Rom, q Existing Water Supply: ❑ Public Water
�`-.- '—�- / ❑Well
Existing Sewage Service: ❑ Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish
two copies of separate drawing This section to be filled out by
Indicate North Town of South Windsor
No. cuts
0
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est. Patch Cost$
Est. Curb Replacement __. _ ft
Est. Curb Unit Price$__eft
Est.Curb Cost$
Est. Traffic Unit Cost$ _/hr
Est.Traffic Control
Amt.of Deposit$
Total Due$
( )Cash OCheck#
Applicant is responsible for contacting the Police Dept.and C.B.Y.D. Paid By
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 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 Excavatlon Permit 08 REV 10-22-08