HomeMy WebLinkAboutStreet Cut Permits 595 Strong Road (2) 1300302 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 12/05/2013
GIS ID: 87000595 FEE: 25.00
MUNIS APPLICATION# 201301785 =: EXPIRATION DATE: 12/05/2014
APPLICANT = 6 LOCATION
NAME: LAYDON INDUSTRIES LLG" ADDRESS: 50�STKONG ROAD
ADDRESS: 51 LONGHINI LANE OTI<R BLAMIkE PHILIP
NEW HAVEN, CT 065r� 595TRONG RD
PHONE SOU I'H-VINDSOR,CT 06074
WORK DESCRIPTION: PAVEI NT RR-sTOKAI ION SOX /
APPLICANT AGREES TO FURNISH THE TOE OI SOUTH WINBSOR THE.AMOUNT OI BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WIND S0R FOR ANY EXPENSES INCURRED BY THE TOWN FO1�vIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TIIE A1'PI ICANT IS FAMILIAR WITH ALA WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS (OUTLINED IN THE TOWN OF SOUTH WIND 'S= TREET CUT PERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
9
12/5/2013 1:36 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /3 0 0 3 0a CONTRACTOR: C_a � jOn J- hd.y s f r)cS
LOCATION: Stf0n �j 'lZoc A
nn
TYPE OF WORK: YGiU2T-r�en . Q esJo ra.i t o n for �.
DATE INSP NEEDED: DATE INSP: ®�
INSPECTED BY: AD
WORK IN
PROGRESS: A 9tb' x . /O / r
IJ
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/2014 Town of South Windsor INPSEMON REPORT 14
Z-01-3c-, APPLICATION FOR STREET EXCAVATION PERMIT IS003al
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: "
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm Li-c f � 1 �'�'1�� 't e S Phone No.&__,_:�
Address of Firm L-C_- i,tiA , Zip Code �5 l
Location of proposed work S 09LI, 9(2�c'k
Describe fully nature of permit re iested
Starting date /Q q / Approx. time for completion L
Call Before You Dig Nod �0�1� Existing Water Supply: ❑ Public Water ❑ Well
Existing Sewage Service: ❑,Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est. Patch Cost$
Est. Curb Replacement ft
Est. Curb Unit Price$ Jft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
O Cash ( ) Check#
Applicant is responsible for contacting Paid By
the Police De t. and CC.B.Y.D.
- I AGREE-TO FU�jNI H TO THE-TOWN-OF-SOUTH WINDSOR THE AMOUNT-OF-BOND-REQUIRED-AND TO-REIMBURSE-THE
WN TO OF SO _V H INDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNEC IT THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS A UT INED IN THE OWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signe : Date: dp �Z3
Title: Driver's License#:
PLEA 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 Fxravat-inn Permit 08 RFV 10-27-08
THE METROPOLITAN DISTRICT . PAVEMENT CUT DATE: �r
BILL JOB YES❑ NOO'�- WO## �rS�7 J4 y
ADDRESS TOWN -5 �r'rir o�., STATE HIGHWAY YES❑ NO�
DR W SKETCH SHOWING LOCATION AND SIZE OF CUTS AND CUT MADE IN
p CROSS SECTION OF PAVEMENT'
f� STREET BIT. CONC. 2r CONCRETE. ❑ PREMIX ❑
SIDEWALK BIT. GONG. ❑ CONCRETE ❑ FLAG ❑
CURB BIT, CONC. ❑ CONCRETE ❑ STONE ❑
DRIVEWAY BIT, CONC. ❑ CONCRETE ❑
GRASS LOAM&SEED NEEDED YES❑ -
REASON FOR CUT:__
NUMBER OF CUTS-
DATE OF FIRST CUT
IS JOB COMPLETED: YEV<NO❑
FOREMAN: L `
REPLACEMENT'PAVEMENT CONTRACT NO
BIT.GONG. ❑ CONCRETE ❑ PREMIX ❑
DATE COMPLETED:
ACCOUNT NUMBER:_
CALCULATIONS
OF CUT ITEM ITEM ITEM# ITEM#
Eck r-- ;
it 0
�� � ���®/ COPIES !`I" PAVING INSR 0PERATIQNS UTILITY SERVICES CONTRACTOR
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