HomeMy WebLinkAboutStreet Cut Permits 726 Foster Street (2) 1 .. .v Ili vi avU 1 ri w INIJJVK, U 1
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 06/05/2014 ;
GIS ID:33600726 = FEE: 0.00
MtJNIS APPLICATION# 201400714 PIRATION DATE:
APPLICANT
LOCATION
NAME: YANKEE GAS - �1DDRI V16TO TER STREET
ADDRESS: 112 PROSPECT HILE I %%
� A TYLE GREGORY B&ELLEN M
EAST WINDSOR,C_' 8 %�
7604rER ST
�� �� 9UTH IOVINDSOR,CT 06074
PHONE 860-292-2242 gg '
It
WORK DESCRIPTION:
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APPLICANT AGREES TO FURNISH THEE OVI fFOIrTLID WV
ORE AM( I I O BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AICP�NS IN � IHE TQWIOIv1AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TIC APPLINNT IS A I Yt�R 1I�# ID I L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLIINED INN�THE
/TOWN 61 S(}JTII DSI STREETUUT`PE MIT MANUAL.
ISSUED BY DT'E' SCTED INSPECTED BY
6/5/2014 11:12 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
W
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR:
LOCATION: 7o?(n S jn�':L-o
TYPE OF WORK: v C Jra P//i,
DATE INSP NEEDED: DATE INSP: �s
INSPECTED BY: 6 D
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: CAN DATE:
S/2014 Town of South Windsor INPSECTION REPORT 14
11—^—� I . _—
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 $25.00
Name of Firm YGnVzr—;, Gc.s Phone No. ��d'29z-22t9
Address of Firm I I Z P.�-s e c( 1( 2b.-d , �W;w� - CT o�3�3 Zip Code 0&076
Location of proposed work M., O Zb%"
Describe fully nature of permit requested - �tL21/
Starting date 3 Call Before You Dig No Q011 o
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price
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.D
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 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR' RE T CU ERMIT MANUAL. ,/�
Signed: Print Name '"k "'1 Date:
Street Excavation Permit 2014