HomeMy WebLinkAboutStreet Cut Permits 66 Cadbury (2) 1400040 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 03/27/2014
GIS ID: 15900066 FEE: 0.00
MUNIS APPLICATION# 201400286 EXPIRATION DATE:
APPLICANT - LOCATION
NAME: YANKEE GAS ADDRESS: 66 CAbBURY
ADDRESS: 112 PROSPECT HILE'P = O NHR �EMAI EK DEBRA A
EAST WINDSOR, CTI208$ S ATBURY
�Ot1��I WINDSOR, CT 06074
PHONE 860-292-2242
WORK DESCRIPTION: EX AMATT�J INSfiALL GAS SERICERlJI1 CURS TO HOUSE
APPLICANT AGREES TO FURNISH TH1 4 O T OF SOU-fflg tIIN TpF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY f-E1*ISES INCURREb:BY THIJ�( WI±T FO MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TIE APPLICANT IS FAMII IAR WIITH AMID WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN b SOUTH WINDSR' TREI T CUT P2IIvIIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
3/27/2014 9:54 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: q o00 qo CONTRACTOR:
LOCATION
TYPE OF WORK: 1 h S'l G 1 I
DATE INSP NEEDED: DATE INSP: ► �l 9l
INSPECTED BY: I' , _
WORK IN
PROGRESS: c> C,� o� - ��.�. � , � ,rZ re
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: _ 1 DATE: y' ` .
W/2007 Town of South Windsor INPSEC RON REPORT 07
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 $26000 LOP-# 8f'� Z. 0 _77/
Name of Firm Phone No.
Address of Firm Z' V E 0 a e if��' , t� Zip Code OY
Location of proposed work 6 6 C
Describe fully nature of permit requested .k X r ON WCrLs TO N aVA It G'Ac1' (Y.1W(C C
uF19 4 o2t 1� F
Starting date_ 3 `3 11 '14� Approx.time for completion
Call Before You Dig No. 2-a/ Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR.THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT;INCLUDING.ANY INCREASES IN PATCH AREA,CURB
{.ENGTH,TRAFFIC_CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of piopos work or fumish This section to be filled out by
two copies of separat d awing Indicate.North Town.of.South Windsor
No.cuts
f
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
i rI
i
Est.Patch Unit Price$ /sf
c, Est.'Patch Cost$
v
j, Est.Curb Replacement ft
'tea Li Est.Curb Unit Price$ /ft
�• Est.Curb Cost$
Est.Traffic Unit Cost$ mr
Est:Traffic Control$
Atnt.of Deposit$
Total Due$
O Cash O Check#
Applicant is responsible for contacting 14 kn S Id'1 �� �',
APPI� 9 Paid By .
the Police Dept.andC.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 RULES AND REGULATIONS FOR
PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: �i .�'--��.---� Date: 3
Title:. CCIA 2 S�r /S_4 LQ"/Q A) � r� 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