HomeMy WebLinkAboutStreet Cut Permits 113 Overlook Road (2) ------------
1400338 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 11/25/2014
GIS ID: 67500113 FEE: 0.00
MUNIS APPLICATION# 201401696 EXPIRATION DATE:
APPLICANT LOCATION
NAME: YANKEE GAS ADDRESS: 113.-OVERLOOK ROAD
ADDRESS: 112 PROSPECT HILL RD OWNER. BABOMhCZ CRAIG J&JENNIFER M
EAST WINDSOR,CT--MW88- 113 OVERLOOK ROAD
SOUTH V?INDSOR,CT 06074
PHONE 860-292-2242
WORK DESCRIPTION: EXCAVATE TO INSTALL GAS SERVICE FROM ACROSS THE ROAD
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR THE=AMOU7lFT 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 THE APPLICANT IS FAMILIAR WITH AND WILL.ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
i 1
ISSUED BY DATE I&SPECTED INSPECTED BY
11/25/2014 11:57 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:-7 CONTRACTOR:
LOCATION:.., ST_
TYPE OF WORK: !t1S' a.l� 2 a S ce
DATE INSP.NEEDED: DATE INSP: ►���3
INSPECTED BY: 6-P
WORK IN
PROGRESS: rc��► k �� '►n, tr. 1� Y� � -u �,
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: Iq
S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm A) KFY &0J Phone No. 6 D ^2 q 2^Z Z-SJ-B
Address of Firm_ 7 P IZ--3 S t'WC:5i ! t1 t 0,D 14 k Q �_ Zip Code- c7 8 _
Location of proposed work / 3 S V'jc-Z� pt-)- _
Describe fully nature of permit requestedC
Starting date: l 2- --/ -y � Approx.time for completion t 1)
Call Before You Dig No._"Z- b ((4(�7 0 l D p 9 Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR.THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING.ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch bf proposed work or fumish This section to be filled out by
two copies of separate drawing Ir�cate.North Town.of.South Windsor
No.cuts
Est.Patch Size(s) sf
( � Est. Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
e9.S Est:Traffic Control$
u0 O w At Amt.of Deposit$
Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police Dept and C.R.Y.D.
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 PERMIT MANUAL.
Signed: alaj_�� Date: l Z q ( `
Title:.C-0 a1 S 3-B-U C Q'/r7.tJ 7`L-rC k 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 , Z( �
Street Excavation Permit 08 REV 10-22-08