Loading...
HomeMy WebLinkAboutStreet Cut Permits 407 Niederwerfer Road (2) 1400302 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 10/06/2014 GIS ID:63600407 - FEE: 0.00 MUNIS APPLICATION# 201401417 = IIXPIRATION DATE: APPLICANT , LOCATION NAME: YANKEE GAS 4bbItE98: 40-N.-OI ERWERFER ROAD = „ ©W1ER ,1' RMEEE ELIZABETH CLAIRE ADDRESS: 112 PROSPECT HILL#1$07 WINDSOR, Cl 06098 4It7 i-EDERWERFER RD ` }J-T-H W INDSOR,CT 06074 PHONE 860-292-2242 - - WORK DESCRIPTION: INSTALL GAS SERVICE32-0 miff APPLICANT AGREES TO FURNISH THE SOWN OF S©UTH WINDSOR THE AMOjIIT O BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANY LPENSES INllRRED BY TI3E TQWNFOIMAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMII>AR I WITI AND WIi� ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN dF SOUTH WINDS R'S STREL CUT F'EI4IT MANUAL. ISSUED BY D "TE .=SPECTED INSPECTED BY 10/6/2014 10:50 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** -- --- --- TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: CONTRACTOR: U zr LOCATION: qO 7 42c TYPE OF WORK: DATE INSP NEEDED: DATE INSP: INSPECTED BY: WORK IN PROGRESS: !�C qo 2 All g SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14 I Appl. No. TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT 1540 SULLIVAN AVENUE Date: SOUTH WINDSOR,CT 06074 FEE $25:00 Name of Firm_Xa x) K f Phone No. 8 �� �~2-2-5 Address of Firm_ t_`2 P OTC Ccs Cam Code 06 8 Location of proposed work 07 AJ/6 D E(1,W 6+[z- TZe(-, A- Describe fully nature of permit requested__, 'n ,f✓3-V'1c -F it--,V vvt ,B C(��S S �'f.�, ST9-4 &&T- isal" A)ESN- t( 003 SAA^(,Y16X Starting date °-/ Approx.time for completion-1 Y Call Before You Dig No.2,0 C 3 9 7 9 Existing Water Supply: ❑Public Water ❑Well Existing Sewage Service: ❑Public Sewer ❑Septic PLEASE NOTE: THE DEPOSIT FOR.THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A .PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT;INCLUDING.ANY INCREASES IN PATCH AREA,CURB . LENGTH;TRAFFIC:CONTROL AND HE TOWNS CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OFT H-E TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch bf proposed work or famish This section to be filled out by two copies of separate drawing Indicate.North Town.of.South Windsor No.cuts J Est.Patch Sizes) sf Est.Pvt.Thickness in. 0"7 Est.Patch Unit Pace$ /sf Est.'Patch Cost S Est.Curb Replacement it Est.Curb Unit Price$ /ft Est.Curb Cost$ %6- Est.Traffic Unit Cost$ /hr Est:Traffic Control S lu r .V fLts t cf rz lw 0, I'3 Amt.of neposit S O f. s Total Due$ /j ( )Cash ( )Check# Applicant is responsible for contacting U Paid By the Police Dept.and C.B.Y.D. 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 RULE_S AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: �� Date: ID-2-`"1 Title: . �-E7 �S'�'�u�-Y11� Y �I 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