HomeMy WebLinkAboutStreet Cut Permits 9999 Jonathan Lane (2) TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 06/05/2014 -
GIS ID: 99994780 - =- FEE: 0.00
MUNIS APPLICATION# 201400713 jjp� EXPIRATION DATE:
AM
APPLICAI LOCATION
NAME: YANKEE GAS D" M JCNATHAN LANE
ADDRESS: 112 PROSPECT HILL,
Tf),)�YN1 F SOUTH WINDSOR
EAST WINDSOR,Cif 8$ - 14 SUS LIVAN AVE
c � bLI��I VINDSOR,CT 06074
PHONE 860-20-2242
WORK DESCRIPTION: OFFSETMN RW�I� IISI� I &FOSTER ST
—/ !THE DRAIN LAYER ASSIGNED TO THI§-E I'I I S AN �IyEAE SSUEI $ FI3 /STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FOR I'f AM' HEI? -NDI N' ALL I DRI{SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDAlkQ"L OSHAjToIREMEpI`I'S AID TFIE ATTACHED CONDITIONS.
ISSUED BY DATE INS ECTED INSPECTED BY
6/5/2014 11:04 AM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:_ 1 q()Q/(/L/ CONTRACTOR: n rJ.
LOCATION: 9q Tin r, l ly W
TYPE OF WORK: s T l a 4 m/li n bir
DATE INSP NEEDED: DATE INSP: /3'
INSPECTED BY: (�
WORK IN r�,
PROGRESS:_ `/G t' Cs/9'5 4-0Vc���
e(.J 3 l act�..Ref� ����^-� •�.� c
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:--J��T`�
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 $25.00
Name of Firm Yank Gas Phone No. S36°�29z-2219
Address of Firm 11 Z l�.�s c(- 44,)( C7" Zip Code 0&0'76
Location of proposed work —S� �TNr 1 LAe- Fm-s-po�R Err
Describe fully nature of permit requested OFfSE I C-:�-AS NAA( T� '
Starting date 3 1 Call Before You Dig No o,Q 0 '?, 6-0 8(o
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of se)arate drawing
No.cuts
Est.Patch Size(s) sf
-t� Est.Pvt.Thickness in.
0! Est.Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement ft
r A Est.Curb Unit Price$ !ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price
Est.Sidewalk Cost$
jisN i HAS LA 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.D
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Paid By
€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 LIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR' ST EET U IT MANUAL. ,,/� Z
Signed: Print Name --�0`'S`"� �"1�� � 1 Date: 3
Street Excavation Permit 2014