HomeMy WebLinkAboutStreet Cut Permits 71 Ronda Drive (2) 1400134 TOWN OF SOUTH WINDS.OR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 05/29/2014
GIS ID: 77100071 FEE: 0.00
MUNIS APPLICATION# 201400664 EXPIRATION DATE:
APPLICANT LOCATION
NAME: METROPOLITAN DISTRICT` ADDRESS: 17I RUNDA DRIVE
ADDRESS: 125 MAXIM ROAD OWNER: GLAN6VSKY JAIME L
HARTFORD,CT 06f,14 " 71 -ONDA DR
SOUTH WINDSOR, CT 06074
PHONE
WORK DESCRIPTION: REALA-e-E EXISTING HYDRANT O S f�83 5g
APPLICANT AGREES TO FURNISH THE TORN"OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY&#PENSES INCURRED BY THE TO*N F6i&AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TIE APPLICANT IS FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN bF SOUTH WINDSR'S STREET CUT PERMIT MANUAL.
IN
ISSUE BY DATE INSPECTED INSPECTED BY
5/29/2014 2:42 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I1-160J3Yf CONTRACTOR: I el
LOCATION: 7 f 620ncla D6ve
TYPE OF WORK: i�l����s ►S c J rand Sr�3
DATE INSP NEEDED: DATE INSP: JbIvIly
INSPECTED BY:
WORK IN
PROGRESS: ..A ? -t. S C l'a►a c -} � (�—�(��c s�
OIL, fhoc� a
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/2014 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 $25.00
!�:: . .....--.-.-._......_........-:
Phone No:-..��`t�`--v�t�_`I$�0-•__.
Address of Firm l 2 9 AA A x'I M PW A A I'Lt FO 1119 CT _ Zip Code 061Y
Location of proposed work 31 a0A1 -4 Nk
Describe fully nature of permit requested f2F-A ,4C V kxi-5'i"04 OMA/ �
W A t S:�.
Starting date Call Before You Dig No ► A 1
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COSTOF 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 Wcurb Cut ❑ Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ePublic Water ❑ Well Sewage Service. ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish indicate North Th1l section f4 �t Town n to a filled ou
two copies of separate drawing
.
0 No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ !s#
Est.Patch Cost$
Est.Curb Replacement #t
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
( )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 ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND
THAT I JAMIR WIT D WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOC TP TMANUAL. } �(Signed: PrintName J Qi'tt/ kR Alh Date:Street Exmit 2014
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