HomeMy WebLinkAboutStreet Cut Permits 9 Austin Circle (2) 1300254 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
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DATE: 10/04/2013 % , ,,
GIS ID:05900009 % % FEE: 25.00
MUNIS APPLICATION# 201301443 iWHO IRATION DATE: 10/04/2014
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APPLICANT s LOCATION
NAME: ADVANCED CONSTIJC�I�V / �Wy
RE�` 9 AIST1 CIRCLE
ADDRESS: 5 CHESTNUT HILL RAY11ATHAN JANAKIRAMAN&
STAFFORD,CT 0607 II CIR
-put INDSOR,CT 06074
PHONE 860-519-8442 _
WORK DESCRIPTION: INSTAL, WOO A ���
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APPLICANT AGREES TO FURNISH THE TWIG O�JTIJMD �II BD REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANI# 31IN �IIWN3RAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THI �I'PI-I F Al V = AI W L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OFLH
D T Y-P MANUAL.
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ISSUED BY DATE SV� CTED INSPECTED BY
10/4/2013 10:42 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT:No. 300 CONTRACTOR: nal 060cp 'C6
LOCATION: `�
TYPE OF WORK: /�rD I942 CAty
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, 'FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: 2-1
V/12007 Tavn of South Windsor INPSECTION REPOP.T 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 $25.00
Name of Firm '�C/ ' 'I r < Phone No. �C L
Address of Firm Ch��t r�r `�j;�� ( U/ Code ~
Location of proposed work
' A rn S?IV\ r'f"�
Describe fully nature of permit�requested
Starting date _' Approx. time for completion_ {
Call Before You Dig No. 7�., Existing Water Supply: El Water
y ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
tS TYPI
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH CALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish
two copies of separate drawing This section to be filied out by
Indicate North Town of South Windsor
No. cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness--in.
0
Est. Patch Unit Price$ /sf
l Est. Patch Cost$_ -_
"b Est. Curb Replacement ft
Est. Curb Unit Price$ /ft
Est.Curb Cost$
Est. Traffic Unit Cost$
Est.Traffic Control$
Amt.of Deposit$
Total Due$
( }Cash ( )Check#
Applicant is responsible for contacting Paid as the Police Dept.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 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:_ e /4n',v)
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