HomeMy WebLinkAboutStreet Cut Permits 73 Debbie Drive (4) 1400021 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 02/11/2014
GIS ID:26700073 FEE: 0.00
MUNIS APPLICATION# 201400125 EXPIRATION DATE:
APPLICAl LOCATION
NAME: YANKEE GAS = ADDRESS: 7DEBIE DRIVE
ADDRESS: 112 PROSPECT HILL 1 OWNER: DREZIK CHRISTOPHER&ALISA
EAST WINDSOR,GT- 88 - 7 1SEIBIE DRIVE
S, YTI WINDSOR,CT 06074
PHONE 860-292-2242
WORK DESCRIPTION: EXCAVATE FROM CURB TO HOUSE TO 11�I$ERT SAS SERVICE
APPLICANT AGREES TO FURNISH THE'-TON OFOUTH'WINbSOR THE AMO[7NT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AI;+IYMXPENSES INCURRED BY THE TOWN FOIE-MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF"SOUTH WINDSR'S STREETCUT`P-131C IIT MANUAL.
7 f
ISSUED BY J DATE INSPECTED INSPECTED BY
2/1 1/2014 1 1.:14AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I 'C)00,2-, CONTRACTOR:
LOCATION:_ 73 Dgg 6 ) g
TYPE OF WORK: S L7- �ra S vlG�
DATE INSP NEEDED: DATE INSP: by
INSPECTED BY:
WORK IN
PROGRESS:_ 1�,'�.. c s �� v,c .'.-.�l.,i � 4' �ws-1-� �
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:___` �10 ,�
W/2007 Town of South Windsor INPSEMON REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm A)Kh-Z(4 1" Phone No.jq C `" 29 "2258
Address of Firmer ( IL V n-o,,.S a Zip Code 0 g
Location of proposed work 2 I :p F e2 Is I rE 11241
Describe fully nature of permit requested &0 M iA i2 f V"b 14 D(OS'
Starting date -" Approx.time for completion
Call Before You Dig No.-7—�3 �_Cr c,y& (7. I Jr 2-7 Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage-Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT,PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL-FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or-furnish This segtion to be filled out by
two copies of separate-xfrawing Indicate.North Town of South Windsor
No.cuts
Est.Patch Sizes) sf
Est. Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ A
Est.Curb Cost.$
Est..Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
)Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police De t.and C.B.Y.D.
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'S STREET CUT PERMIT MANUAL.
Signed:� — (�/.< Date: C r
Title:-( �A)J V:(I-U C-V"l 0 A) f Driver's License#: T
PLEASE 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 Excavation Permit 08 REV 10-22-08