HomeMy WebLinkAboutStreet Cut Permits 75 Paper Chase (3) 1400038 TOWN OF. SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 03/19/2014
GIS ID: 69000075 FEE: 0.00
MUNIS APPLICATION# 201400259 1XPIRATION DATE:
APPLICANT .` LOCATION
NAME: YANKEE GASf - ADDRS: A'ER CHASE
ADDRESS: 112 PROSPECT HILL 1 = - C�WNF;R W- SGRAVE RICHARD E&PAULA C
EAST WINDSOR,CITEjCOff8 75`7AIWR CHASE
„= SOUT WINDSOR,CT 06074
PHONE 860-292-2242 = - - _. ;
WORK DESCRIPTION: EXUAATR I INSIlIZT GAS=SEVIETREET TO HOUSE
APPLICANT AGREES TO FURNISH TH>rTO=WI4 OF-SOUTIL WINDa 1Rsi HE AMOUNT F AOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY ExPBI9 OB€MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMILIAR KITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WIIV SR'S STREET CUT IT MANUAL.
ISSUED BY DXM4NSPECTED INSPECTED BY
3/19/2014 8:06 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WIN S R INSPECTION REPORT
PERMIT NO.: / 41W 3 CONTRACTOR; &� , as.
LOCATION: Ise
TYPE OF WORK 6k/r Uri fV IDS 'r 61� Aim-) -sr, � /o v
DATE INSP NEEDED: DATE INSP: 3
INSPECTED BY: _
WORK IN
PROGRESS:.. /t- ma.L a- II X ..7 Y
a r
, �,
Air �22
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES F] 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 $25.00
Name of Firm Y/d 9'Cs6" 6a-212--2Z5�'
Phone No.
Address of Firm I/ 2- Idt I t F Q , , ;UJ o Zip Code C f37
i
Location of proposed work_.;' A p Lc'(_ C 6A',N
I Describe fully nature of permit requested_ �C ✓d`-rk-V- V'rp ! /1!cY t?-V- ko-S
Starting date Approx.time for completion
Call Before You Dig No. `Z0! (�( _ D Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR.THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT;INCLUDING-ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
i
.Show sketch bf proposed work or furnish IThis section to be filled out by
f
two copies of separate drawing Indicate North Town.of.South Windsor
No.cuts
Est.Patch Size(s) sf
i
Est.Pvt.Thickness in.
r Est.Patch Unit Price
1= J
\jq fl(i K 0 kt_jF A S Est.'Patch Cost$
f
- Est.Curb Replacement ft P�f�� cta��S�
Est.Curb Unit Price
Est.Curb Cost$
i
Est.Traffic Unit Cost$ Mr
Est.Traffic Control$
.�� Amt..of Deposit$
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 RULES AND REGULATIONS FOR
PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: � '� � -� Date-
Title:- &9 N J�rX c/c,'i J 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