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HomeMy WebLinkAboutStreet Cut Permits 595 Strong Road (3) 1400158 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 06/11/2014 GIS ID: 87000595 -- - FEE: 0.00 MUNIS APPLICATION# 201400744 - EXPIRATION DATE: APPLICAM LOCATION NAME: METROPOLITAN D TRIG` ADDR9S1ONG ROAD ADDRESS: 125 MAXIM ROADf I QIGIZE PHILIP HARTFORD,CT 06114 S9 S"T ONG ROAD VA ff � gutU ndsor, CT 06074 PHONE WORK DESCRIPTION: RERj E TXj T�NCF I tl U OF J IBER 595 STRONG RD 001 APPLICANT AGREES TO FURNISH THI TOI OY SOUTHI D REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR AIIY XP�N�E INf tl- E TIE AINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND Tf-E A&'LICANT IS L ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN rlF S(3JTH WAIDSIIT T'CIIT°PI IIIT MANUAL. //Q ISSUED BY DAB 1N" -P TED INSPECTED BY 6/11/2014 10:32 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** 35, y� ; TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: J q P015 S CONTRACTOR: YV► PC LOCATION: 9 Sr S�-woaq Qoa /OQl �OcS�' ` S�f S— TYPE OF WORK: CP.Ql a rjo DATE INSP NEEDED: DATE INSP: INSPECTED BY: ED WORK IN PROGRESS: SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: S/2014 Town of South Windsor INPSEMON REPORT 14 APPLICATION FOR STREET EXCAVATION PERMIT A p p DNo. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No. TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINE)SOR,CT'06074 FEE $25.00 Name of Firm T3 � I ��$`�( {� Phone No. 090411 y• � 1 Ej 0 Address of Firm 3-S �44 E Zip Code {-61 Y Location of proposed work S-LI(LO/04 {,q 0 E F Q S Describe fully nature of permit requested _GGPLACIP, kX1 jD� 0R Starting date Cali Before You Dig No a.d l ), 0 q q 3 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 )21 Pavement Cut A Curb Cut ❑ Sidewalk Cut ❑ Existing Driveway,No Changes ❑ 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'sown two copies of separate drawing 0 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$ /it Est.Curb Cost$ Est.Sidewalk Replacement sf Est.Sidewalk Unit Price$ /sf Est.Sidewalk Cost$ Est.Traffic Hours hr Est.Traffic Unit Cost$ /hr Est.Traffic Control$ Amt.of Deposit$ Total Due$ Applicant is responsible for contacting the Police Dept.and C.S.Y.D ( )Cash { }Check# PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Paid By I AGREE TO FURNISH T91 THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANYAR M] ANUAL. RRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMITAND THAT i AM FA AL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR RE Signed: Print Name � /' ! Date: Street Excavation yinit 2014