HomeMy WebLinkAboutStreet Cut Permits 421 Quarry Brook Driv (2) 1400239 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/14/2014
GIS ID: 74100421 FEE: 25.00
MUNIS APPLICATION# 201401113 _ 13XPIRATION DATE: 08/14/2015
APPLICANT LOCATION
NAME: PREVITI BROTHERSND SdNS IBC ADDRESS: 424-Qik4ARRY BROOK DRIVE
ADDRESS: 123 PROSPECT HILL R 1D OWNER LACAMA CONSTRUCTION COMPANY
COLCHESTER, CT 06,rf-5 I&� I. S DEANE HWY
10
WETTE SFIELD, CT 06109
PHONE i ---
WORK DESCRIPTION: INSTAL&NEW SIDEWALK FdR DRIVEWAY.
APPLICANT AGREES TO FURNISH THE;OWN OF SOUTH WINDSOR THE AMOUNT OF BAND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AI 1'`Is{PENSES INCURRED BY THE Tib'ka&q-5AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THI APPLICANT IS FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED
�I�N�THE TOWN CSF SOIJTII VyI1tIDSOR':S STREET CUT PIfiIN1IT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
8/14/2014 8:56 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:, I q 00 o?,3 2 CONTRACTOR: Err,e\1 ti t t b erg cle did r�S
LOCATION: 2t 1 lt� A1)1)
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:* �n
WORK IN
PROGRESS: 1✓ �'i w [�. &yvwjs ar,r�
W �C
, T
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: _ `�7�,�� LA_
SJ2014 Town of South Windsor INPSECTION REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00
Name of Firm eq l� &�- --� Sanr= Phone No. a2 Q 30( z g 0 2-
Address of Firm " Dr-r. L C!'r Zip Code 06,0
Location of proposed work
Describe fully nature of permit requested
0x01("
Starting date Call Before You Dig No z-
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TO WS CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut a Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawifg
0 No.cuts
Est Patch Sizes) sf
Est.Pvt.Thickness in.
Est Patch Unit Price$ Jsf
Est.Patch Cost$
Est.Curb Replacement ft
rn p i0 L jy.> ; rr Est Curb Unit Price$ /ft
EsL Curb Cost$
�
L� Est.Sidewalk ReplacementZ- sf
Est.Sidewalk Unit Price$ _/sf
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
1
JJ Amt.of Deposit$
Total Due$ t
Applicant ( )Cash ( )Check#
App' responsible for contacting the Police Dept and C.B.Y_D
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Paid By
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 PERT T MANUAL
Signed: !/!J Print Name ��( � � `fit I�7t Date. 1
Street Ex Pernfit 2014