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Home My WebLink AboutStreet Cut Permits 168 Graham Road (5) 1400004 PERMIT NUMBER TOWN OF SOUTH W I N D S O R STREET CUT PUBLIC UTILITY DATE: 01/14/2014 GIS ID:37500168 = = ,- MUNIS APPLICATION 4 201400030 ' FEE: PIRATION DATE: 0.00 APPLICAN 01/14/2015 NAME: YANKEE GA ADDRESS: 112 PROSPECT HILL Imo- _ LOCATION - ADDRE� HAM R AOR AO D EAST WINDSOR, C 6 $$ © H IUPCIINpS MARY LOU&SUSAN M PHONE . 6"L INGTON ROAD 860-292-2242 = W VINDSOR,CT 06074 i� WORK DESCRIPTION: EX �SAD 2©II too APPLICANT AGREES TO FU I _ E %� Ujq THE TOWN OF SOUTH WINDSOR FOR Ali FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH-W4Nt CONNECTION WITH THIS PERMIT AND TIC APIND SQUIRED AND TO REIMBURSE OJTI WDE �W -ND OR REPAIR WOE{IN A W-LL ABIDE BY THE RULES AND REGULATIONS T IITPE1vIITMANUAL. ISSUED BY DATA PCTED ul4izoI4I:4oPM INSPECTE BY*** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** AVA. = ; „ � ; -" TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: /� pocky CONTRACTOR:_ �Ae"\L� LOCATION: ADDRESS: TYPE OF WORK: DATE INSP NEEDED: DATE INSP: r 1 INSPECTED BY:_ ! n WORK IN PROGRESS: oe INPUT: DATE: t43� APPLICATION FOR STREET EXCAVATION PERMIT 140000¢- Appl. No. TOWN OF SOUTH WINDSOR Permit No. PUBLIC.WORKS DEPARTMENT '1540 SULLIVAN AVENUE Date: SOUTH WINDSOR,CT 06074 FEE $25.00 Name of Firm �lGn(� �� s S�� c �s CO m G,, Phone No. PE� Z 22 7 AddressofFirm tt 2 gas �� ' t��1 gcP, c'r Wrno( sol C 1 Zip Code aGO�i Location of proposed work Ca 8 G r C' h r MT Describe fully nature of permit requested E11- cP v t G f r n c Starting date 2 / C Approx.time for completion y Call Before.You Dig No. 2 o 1 q Z O 1 16 '7 Existing Water Supply: ❑Pubr Water ❑Well Existing Sewage Service: ❑Public Sewer ❑Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH;TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH 1S TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show,sketch of proposed work or fumish This section to be filled out by two copies of separate drawing Indicate.North Town of South Windsor //�� //�� t No.cuts acYl PAC Est.Patch Sizes) sf VV . °a C Est.Pvt.Thickness in. A T) Est.Patch Unit Price$ /sf Est.Patch Cost$ U ( R G 7 Est.Curb Replacement ft Est.Curb Unit Price_$ Est.Curb Cost$ Est.Traffic Unit Cost$ fir Est.Traffic Control$ Amt.of Deposit$ Total Due$. ( )Cash ( )Check# Applicant is responsible for contacting Paid B the Police t.and C.B.Y.D. Y 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 TH TOW-N OFF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: Date:_ . t Lt'cff2U<Cl Title: t G Ca n s 7-GYM 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. i t 70* f �. :. . . . . . . . .. 52r v i I .......... 1rencLn �ANM 1Z� , 0 Sv UT 14 VJ !iX CGV Cyr, '. . . . . . . . . . . . .. . . . .. . . . I v�!os C d c:>,S Sep v fC? ------- ( � W encLn d— G (ZA- kfAnn 0 SouT 14 VJ t o'R /Y)/9 ( le/ ?� CG v��j CGh CBYD Locate Request Routine (CALL BEFORE YOU DIG - CT) 01/10/2014 14:21:21 13-5G YANK/G -C1 -CW -GV -OT -SW -T5 Date: 01/10/2014 Time: 14.21 Request #: 20140201967 Prev. Request #: Latitude: 41.8490526 Longitude: .-72.5575644 Address: 168 Street: GRAHAM RD Town: SOUTH WINDSOR Nearest Cross Street: HAYES Type of Work: INSTALLING GAS SERVICE Area is Marked: YES Remarks: WORKING FROM GAS MAIN BEHIND CURB, CROSSING STREET TO HOUSE. Start Date: 01/15/2014 Start Time: 08:00 Caller: MIKE HANECAK Call Back: Phone Number: (860) 292-2247 Alt. Phone: Fax #: Email: Contractor: YANKEE GAS Excavator: YANKEE GAS , RH WHITE Address: 112 PROSPECT HILL RD. City: EAST WINDSOR State: CT Zip: 06088 ...............__..-._.,.... .._ ... ...,.... .,..,,, .. ._._._ Were pre-construction marks visible? ❑ Yes ❑ No ......... ........... ....... ........ ......... .."... .. ................................ ....... .......... ......... .......... ........ ......... ........... .................. What facilities were marked? ❑ Main ❑ Service ❑ Both _..._...-_....,........... _., Main facility material type? ❑ Steel ❑ Plastic ❑ Cast Iron ........ I'll ..... ....... ........ Service facility material type? ❑ Steel ❑ Plastic ❑ Cast Iron ......................1—11,11,11..,.,...,"",__.._.�—___-----------------,...,...._ __.... .........,................._.......... -.. _ � _.__�.._............................. How were the gas facilities located? ❑ Conductive ❑ Inductive ❑ Measurements ......................................................................................................................................................................................._.......................................................................................................................................................................................................................................................... Where was the connection made? ❑ Meter Value ❑ Test wire in box ❑ Tracer wire on service ❑ Direct connect to pipe ............._.._-------- _..__. _... ........., .................. Did measurements match the signal? ❑ Yes ❑ No What was used for measurements? ❑ GIS ❑ Service Card ..........I............ ......... ......... ........ .. ...... ......... ......... How was the area marked? ❑ Paint ❑ Stakes ❑ Both _... ._ . .. _ .,_ —..�. --------,..... _,. _� . .�. ,., ..............—..___- Who was the site verbal contact? ............................�....__ .._..�. �.........�_.......................... .. _ ... ...... � _,..,, .. �... .....,. .. ............................................ ............... Work completed by: ............._......... . ................. .....................I.................................... ........ ......... ......... ........- ....... ......... ......... ......... ..........