HomeMy WebLinkAboutStreet Cut Permits 713 Foster Street (2) U W ICI UP Nu 1 W NDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 06/05/2014 ;
GIS ID: 33600713 FEE: 0.00
MUNIS APPLICATION# 201400719
EXPIRATION DATE:
APPLICAI
- WO LOCATION
NAME: YANKEE GAS %ADDRESS 7I�FC-TER STREET
ADDRESS: 112 PROSPECT HILTv RIB RAN` HORACE V JR
EAST WINDSOR, C �O87OTER STREET
'MO-4 wftmuo-W-
- H VINDSOR,CT 06074
PHONE 860-292-2242
IMF-Al
WORK DESCRIPTION: OFIfi1i'INSIIJ1
APPLICANT AGREES TO FURNISH THE`TOI Q 30trIID } �ILAMDT pF IjND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AARRENS E I C REEF Vat-HJl- p�JTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TF A�'I�I LAL�iT IS-T`AIILA FII t VI L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TO WN C SO 1 H WI1�II fiI BTRIW T`PEI IVIIT MANUAL.
ISSUED BY DAIIPECTED INSPECTED BY
6/5/2014 12:17 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: Z ZQQlY(6 CONTRACTOR:
LOCATION: 3 flS � �,�r
TYPE OF WORK: _S- orI a (,ka I I1'�
DATE INSP NEEDED: DATE INSP: '/
INSPECTED BY: 8Z) —
WORK IN
PROGRESS: Y&-ikk-e 6,45 &a_s r"r4--J n
S Cl) -po r
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: 1
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 $25.00
Name of Firm Phone No. Q60--z'7z-2,2t9
Address of Firm 11 Z Rr spec- W)f iZo E,6fi WAA5—- c--T Zip Code 00 0'76
Location of proposed work 713trT
Describe fully nature of permit requested k2f-N M
Starting date Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWNS CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing -
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
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$
( }
Applicant is responsible for contacting the Police Dept.and .D ( )Cash Check#
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 A [LIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSO ' S ET PERMIT MANUAL. /
Signed Print Name_ --���5�° ` r� Date:1p/ /ems
Street Excavation Permit 2014