HomeMy WebLinkAboutStreet Cut Permits 64 Debbie Drive (3) 1400020 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 02/11/2014
GIS ID:26700064 FEE: 0.00
MUNIS APPLICATION# 201400122 - EXPIRATION DATE:
APPLICANT = LOCATION
NAME: YANKEE GAS ADDRESS; 64`DE$BIE DRIVE
ADDRESS: 112 PROSPECT HILL J OWNER: KRAT GREGORY&CATHERINE
EAST WINDSOR,C-F 88 44bEB$IE DRIVE
PHONE 860-292-2242 -- ,
Soufli Windsor,CT 06074
WORK DESCRIPTION: EXA4TE FROM ACROSS THE STREET TO INSERT GAS SERVICE
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WIND THE AMOUNT-OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY-EXPENSES INCURRED BY THE TOWN FOWMAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANPIS FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSR'S STREET CUT=PERMIT MANUAL.
G' llgf 100 1.vg /
ISSUED BY DATE INSPECTED INSPECTED BY
2/1 1/2014 1 1:11AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: l y000 D CONTRACTOR:
LOCATION:
TYPE OF WORK: Fvczya Dib 6(vas, ' '7-z,- sfr-cr 1`z
DATE INSP NEEDED: DATE INSP: ..7 a t
INSPECTED BY:-
WORK IN
PROGRESS: G15
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
W/2007 Town of South Windsor INPSECTION 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 $25.00
Name of Firm tj i,E _ Phone No.�' ® 2.
Address of Firm___ I ' toIL 06 C E C- ' U 4!11 r b '�I�r � Zip Code 01 Q <9
Location of proposed work ( 1) le I& g a e
Describe fully nature of permit reyue3sted_j })�C 1�V— IZ o fM C_ m-0 S T-14 F f C(`
Starting date Approx.time for completion
Call Before You Dig No._'ZO I�'Z 1 j 2. Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑Septic
PLEASE NOTE:,THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT;INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
.Show sketch of proposed work or fumish This section to be filled*Sit by
two copies of separate drawing Indicate.North Town of South Windsor
No.cuts
Est.Patch Sizes) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /It
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
' Est:Traffic Control$
Amt.of Deposit$
: a g( Is Total Due$
O Cash O Check#
Applicant is responsible for contacU Paid By
the Police Dept.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 RULE_S AND REGULATIONS FOR
PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: .''l
Title: QJ7(Z-Q C-V 3 14 V_rC1i Drivers License#:
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