HomeMy WebLinkAboutStreet Cut Permits 138 Ayers Road (2) 1400070 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 04/22/2014 s
GIS ID: 06900138 � FEE: 0.00
MUNIS APPLICATION# 201400400 ti p k ` 7' FPIRATION DATE: 04/22/2015
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APPLICAN - � j�5 �Y �,w LOCATION
NAME: JDC ENTERPRISES C, QDDRE $ „ '391�8`A�ERS ROAD
ADDRESS: 420 JOHN FITCH B � t 4,= � � e� "$OUTIxWINDSOR TOWN OF 06
PO BOX 905 f � i YESOAD
SOUTH WINDSOR, C 16 FY Rol,OUT VINDSOR,CT 06074
PHONE ... z x
WORK DESCRIPTION: INS At , � pF r� EER CONCESSION TO MAN
HOL ST `FO��
APPLICANT AGREES TO FURNISH THEJ0� ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AIY y4ENIfIC� T ITWIxIFOT AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND Tk F4LCA—N 3S V ITH G A LL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN( 55O W D RsR- TR L�IT�PF MIT MANUAL.
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ISSUED BY D.4Ix IIvSP CTED INSPECTE BY
4/22/20I49:40AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: �� CONTRACTOR: __ J -�
LOCATION: 1 D iu leck
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: ��,
INSPECTED BY: Bb
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED, ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: '��
S/2014 Town of South Windsor INPSECTION REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 / FEE $25.00
Name of Firm e'1-01Z_ g IlVe- Phone No 00
Address of Firm /f@ 'SIP ) ®� ���� �'® �� �� V Zip Code
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Location of proposed w rk .3
Describe fully nature of permit requested
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Starting date —! Call Before You Dig N
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATGH�UT IT COULD BE LAT THAN A YEAR.
Applicable: ❑ No Pavement, Curb or Sidewalk Cut C� Pavement Cut Gurb Cut ❑ Sidewalk Cut
Check pp
VExisting Drive; Public
y o Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: Water y❑ Well Swage Service: Vpublic Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No. cuts
Est. Patch Size(s) sf
Ud Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
� 1'�
Est. Patch Cost$
Est. Curb Replacement ft
e Est.Curb Unit Price
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$_ /sf
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
( ).Cash ( ) Check#
Applicant is responsible for contacting the Police Dept.and C.B.Y.ID
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES 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 AMILIAIWI H AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WIND R'S T E PERMIT NUAL.
Print Name Date:
Signed: -
Stree xcavation Permit 2014
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