HomeMy WebLinkAboutStreet Cut Permits 1010 Pleasant Valley (2) 1400318 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
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DATE: 10/29/2014
GIS ID: 72901010 FEE: 0.00
MUNIS APPLICATION# 201401553 EXPIRATION DATE:
APPLICANT LOCATION
NAME: YANKEE GAS ADDRESS: 10I0 PLEASANT VALLEY ROAD
ADDRESS: 112 PROSPECT HILL RD OWNER: FRITZ JOHN
EAST WINDSOR,CT 66088 18 RU'BYRD
MARLBOROUGH,CT 06447
PHONE 860-292-2242
WORK DESCRIPTION: EXCAVATE TO INSTALL GAS SERVICE GAS MAIN IS BEHIND CURB LINE
APPLICANT AGREES TO FURNISH 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 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.
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ISSUED BY DAT INSPECTED INSPECTED BY
10/29/2014 2:39 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR:
LOCATION: 614 Cc
(jig Aou
TYPE OF WORK: J"s kk9al Gmeh l�
DATE INSP.NEEDED: DATE INSP: /dt 3
INSPECTED BY: 6 D
WORK IN
PROGRESS:
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: LIN\ DATE: .�- AVA
S/molloy/forms 2014 Town of South Windsor INPSEMON 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 $25.00
Name of Firm Yav,kee C-jc4-S Se, Vrces Corn DAn Phone No. (0(6� Z`?-ZZY?
Address of Firm I I Z 4 (I E�d w(�,dsor c-r Zip Code d�F
Location of proposed work -eP4 CAw Ug
Describe fully nature of permit requested �x c�vG i� fo i/7 was sec v fc-e - S-145 ("CA;n 15
heh� h4 c-ur6line
Starting date ac-4- 2 o/`� Call Before You Dig No 2 0 / `43 D l 9 U 9
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway,No Changes D Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
W. U eL(.Z Z , a G 0 Est.Patch Sizes) sf
Est. Pvt.Thickness in.
c.9 �1� � 2v1.� 43v 1 ' 0
Est. Patch Unit Price$ /sf
Est.Patch Cost$
Yl Est.Curb Replacement ft
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 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S//S''TREET CUT PERMIT MANUAL.
Signed: /fie Print Name (� c6f-C 14(XV)ec� �� Date: lOJ'n !�
Street Excavation Permit 2014
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