HomeMy WebLinkAboutStreet Cut Permits 42 Debbie Drive (2) 1400012 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 02/11/2014
GIS ID:26700042 FEE: 0.00
MUNIS APPLICATION# 201400112 - EXPIRATION DATE:
APPLICANfi - LOCATION
NAME: YANKEE GAS IADDRES-S: DEB 42 BIE DRIVE
ADDRESS: 112 PROSPECT HILL Imo? = OWNER: SPADtCCINI RICHARD E&LINDA J
EAST WINDSOR, O &8
42 `IE�BIE DRIVE
C;T
SOtJTH=WINDSOR,CT 06074
PHONE 860-292-2242
WORK DESCRIPTION: EXCAVATE TO INSERT GAS SERVICE /
APPLICANT AGREES TO FURNISH THE TOII OF SOUTH WINDSORTHE AMOUNT OF$OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A1kIY E�{PENSES INCURRED BY THE TOWN FOJ"MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND T IE APP�!ICANT IS FAMILIAR WITH-,IN WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN(YF SO JTH WINDS R'S STREET CUT M--P6IIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
2/11/2014 8:18 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
F :;
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: QC�I CONTRACTOR: LIP.e-
LOCATION:
TYPE OF WORK: n_ e rz., c-'e_
DATE INSP NEEDED: DATE INSP: �y
INSPECTED BY:
WORK IN
PROGRESS: ..
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: �- DATE:
WJ2007 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 $25.00
Name of Firm G Phone No.8 lC
Address of Fir Z- 92 J �-V" t ( .(A). Zip Code ti 6 cc
Location of proposed work !Lz_ 1 I LC O O ", ALL -
Describe fully nature of permit requested Z-)-Cc) yp/ j� I-D I A3 'I'(LVV 614 Is J'ACYIC�
Starting date_ 2- Approx.time for completion
Call Before You Dig No.'ZO l q b !T 6 0g.lo Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR.THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A-YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch Of proposed work or fumish This section to be filled out by
two copies of s 3parate drawing Indicate.North Towrl.of.So.-th Windsor
No.cuts
f 2 Est.Patch Sizes) sf
Est.PA.Thickness in.
Est.Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
U" Est:Traffic Control$
Amt.of Deposft$
s.Lr a
14-/.
Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting 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: CAA Q4-4 Date:
Title... (2 4 O`Jyf, u cv 1 3 .0 v,:CC b Driver's 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