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HomeMy WebLinkAboutStreet Cut Permits 9999 Clark Street (3) 1400334 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 11/17/2014 GIS ID:20409999 FEE: 0.00 MUNIS APPLICATION# 201401628 EXPIRATION DATE: APPLICANT LOCATION NAME: METROPOLITAN DISTRICT ADDRESS: CLARK STREET ADDRESS: 125 MAXIM ROAD OWNER: SOUTH WINDSOR TOWN OF HARTFORD,CT 06114 1540 SULLIVAN AVE PHONE SOUTH WINDSOR,CT 06074 WORK DESCRIPTION: HYDRANT REPLACEMENT S/W CORNER OF STANLEY ON CLARK STREET 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. ISSUED BY DATE SPECTED INSPECTED BY 11/17/2014 10:53 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** -------------- TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: CONTRACTOR: LOCATION: S1A) ce,2r?9r of- S7unl,Pv on C,lGyzk TYPE OF WORK: DATE INSP NEEDED: DATE INSP: INSPECTED BY: WORK IN PROGRESS: SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14 MD-039,Rev 2112 THE METROPOLITAN DISTRICT - PAVEMENT CUT DATE: ADDRESS"1AC ❑ YES ko WO#_,"_0- 3 CLOSEST STREET _s-�cUm Icy TOWN��y' ��1t1L��jUr STATE HIGHWAY ❑YES KENO DRAW SKETCH SHOWING LOCATION AND SIZE O CUTS AND CUT MADE 1N ' CROSS SECTION OF PAVEMENT ' ❑STREET ❑BITUM. ©GONG. ❑PREMIX .. ❑SIDEWALK ❑BITUM. " ❑ CONC. ❑FLAG " El CURB ❑BITUM. ❑CONC. ❑STONE ' ❑DRIVEWAY ❑BITUM. ❑CONC. " /GRASS LOAM&SEED NEEDED )(YES ❑NO m REASON FOR CUT:-13-3-t). P.e,p��iC P @N� o Z DEPTH OF EXCAVATION: . NUMBER OF CUTS: Z DATE OF FIRST CUT- �, " f-7.5 IS JOB COMPLETED: YES ❑NO t L o *,, Iley,FOREMAN: o REPLACEMENT PAVEMENT CONTRACT NO.: BITUMINOUS ❑ CONCRETE ❑ PREMIX CI DATE COMPLETED: ACCOUNT NUMBER: G' . CALCULATIONS NO. OF OU ITEM# ITEM# ITEM# ITEM# N PRESS HARD, a3 COPIES PAVING INSPECTOR CONTRACTOR ( LLO