HomeMy WebLinkAboutStreet Cut Permits 8 Paper Chase (3) 1400043 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 03/27/2014
GIS ID:69000008 FEE: 0.00
MUNIS APPLICATION# 201400289 EXPIRATION DATE:
APPLICAa� LOCATION
NAME: YANKEE GAS ADDRE---S.' 8- PER CHASE
ADDRESS: 112 PROSPECT HILL RD = = ONR CHERIIA MOHAMAD
10
EAST WINDSOR,GTia& 8 M AR CHASE
= S07I II WINDSOR,CT 06074
PHONE 860-292-2242
WORK DESCRIPTION: GAS LWAk - =,
APPLICANT AGREES TO FURNISH THI R O�N OF SOUTFT YsrINDS(}RTH AMOUNT OF'BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A1IY EX'EIISES F1CURRE7➢I3I'THE I O —FOI MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TFE APPLICANT IS FAMILIAR WIT�I AID WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TO WN CIF S(SUTH W1IVD R�S ET CU I PFR1v1IT MANUAL.
ISSUED BY DATE INSP CTED INSPECTED BY
3/27/2014 11:03 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: IL
ODb CONTRACTOR: -�
LOCATION:
TYPE OF WORK:_ (l SIC-
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: BQ
WORK IN
PROGRESS:_ L
SEPTIC TANK PUMPED SMASHED FILLED
-WIT-
, NESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:5\w\\A
W/2007 Town of South Windsor INPSECTION REPORT 07
Al't'LIL:A I IUN t'UH S I NttT tXCAVATION PENMI
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074.
FEE-$26'00
Name o€Firm —
Phone_No. C) r
Address of Firm Tip Cody/ _
Location of proposed work
Describe fully nsture,of permit request
Starting date Approx.time for completion
Call Before.You Dig .lo. Existing Water Supply: Q Public Water ❑Well
Existing Sewage Service: Q Public Sewer 0 Septic
PLEASE No THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
1PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINALCOST OF THE
PERMANENT PATCH ANDCURB REPLACEMENT;INCLUDING ANY INCREASES IN PATCH AREA,CURB-
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A=YEAR OF THE TEMPORARY:PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be-
two out by
two copies of separate-drawing: Indreate.North Towq.of South Windsor
i
No.cuts
;! at.Patch Sizes) __ "sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replace neat ft
Est.Curb Unit Price$ !ft
Est.Curti Cost S
Est..Traffic Unit Cost$ Ihr
Est.Traf tic Control S
A nt.of Deposit$
Total Due S
O Cash O 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 A O TLINED IN TH O OF SOUTH WINDSOR'S STREET CUT P MIT UAL,
Si red:
9 Date l
r1 r Tt e.
- 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 dOBSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08