HomeMy WebLinkAboutStreet Cut Permits 184 Foster Road (3) 1400080 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 04/3 0/2014
GIS ID: 33300184 FEE: 25.00
MUNIS APPLICATION# 201400460 EXPIRATION DATE: 04/30/2015
APPLICANT LOCATION
NAME: BARBER UTILITIES LLC ADDRESS:' 184'MSTER ROAD
ADDRESS: 35 PINNACLE ROAD OWNER: AUGER MATTHEW
ELLINGTON,CT 0029 ; 184 FOSTER ROAD
SpVTH WINDSOR,CT 06074
PHONE
WORK DESCRIPTION: INS TAE-L WATER SERVICE /
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BONDREQUIRED RE UIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY-EX-PENSES W INCURRED BY THE TO FOR"MIN ATENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APLICANT IS 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.
(D cl
ISSUED BY DATE INSPECTED INSPECTED BY
4/30/2014 11:29 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
, r
PERMIT NO.: l7`/"c7 b CONTRACTOR:
LOCATION: P-OCR Gp
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: is 10C Ily
INSPECTED BY: 81>
WORK IN
PROGRESS: �4�� -. n�� A °S s Cam-
Fe"."
Tr
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: /0 -do J
S/2014 Town of South Windsor INPSEC 1ON 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 $25.00
Name of Firm 'B19""E. 617 LJ 97!�s U—C Phone No.dg -9?2_Z3110
Address of Firm ?7 41 4WA& ZG1106 ry G7' Zip Code 4642-1
Location of proposed work 9V I
Describe fully nature of permit requested /NFL
Starting date Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE.
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement, Curb or Sidewalk Cut Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts I
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
IG
V/yb,'� Est. Patch Unit Price$ _/sf
I Est.Patch Cost$ 11 6 OV
Est.Curb Replacement ft
Est. Curb Unit Price$ /ft
Est.Curb Cost$
Est. Sidewalk Replacement sf
Est.Sidewalk Unit Price
a f
Est.Sidewalk Cost$
Est.Traffic Hours hr
J
Est.Traffic Unit Cost$ /hr
V I U Est.Traffic Control$
3 Amt.of Deposit$
Total Due$ (p 26
( )Cash ( )Check#
Applicant is 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 EXPENSE URRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND
THAT I AM FA t AR WITH A D ILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED 1N THE TOWN OF SOUTH
WINDSOR'S ET U E M MANUAL.
Signed: Print Name � /Q �i 5�� � _ Date:
Street Excavation Permit 2014
TOWN OF SOUTH WINDSOI
ENGINEERING DEPARTMENT
ADDRESS PERMIT NUMBER
INSPECTOR TEMP. PATCH DATE
INSPECTOR COMPLETION PATCH DATE 70,Li
_.