HomeMy WebLinkAboutStreet Cut Permits 7 Abbe Road (3) 1400284 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 09/29/2014
GIS ID: 00600007 FEE: 0.00
MUNIS APPLICATION# 201401364 EXPIRATION DATE:
APPLICANT = - LOCATION
NAME: YANKEE GAS ADDRESS: 7 A13B1%ROAD
ADDRESS: 112 PROSPECT HILL RD OWNER: BEAUDEAU WILLIAM J&LINDA L
EAST WINDSOR,CT 0608 7'AR-RE ItOAD
SOJ`TH WINDSOR, CT 06074
PHONE 860-292-2242
WORK DESCRIPTION: INSTALI;SAS SERVICE FROM MILLER ROAD TO REAR OF HOUSE
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 TO INTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TM APPLICANT 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 INSPECTED INSPECTED BY
9/29/2014 2:19 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: / 7 6dd CONTRACTOR: �OLV)az
LOCATION: ? Abbe 2oad
TYPE'OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: lin
WORK IN
PROGRESS: 7 �
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C -' DATE:
S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14
Ir-ug • I_g%-rr"111L/11 1 WI-1 01 RGG t GAV#AvMI iVIN r"nivil 1
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25900 U'0 1� C 'z_( 6 D 4-
Name of Firm Y Id ti l<1 64:S . Phone No.
Address of Firm l 1 '2 ' it ��fi:•_'' l�Y I l rp Code t) D`;
Location of proposed work R D o - M y t t`it- (Lb Sib d IF f g-D P
Describe fully nature of permit requested A) S �'�(l a9
Starting date= /t7" /f Approx.time for completion
Call Before You Dig No.'Z J C� `I {�% 7. I Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR.THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
.PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT;INCLUDING.ANY INCREASES IN PATCH AREA,CURB
. 'LENGTH;TRAFFIC:CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A-YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch bf proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town.of.South Windsor
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost-$
Est.Traffic Unit Cost$ /hr
Est'.Traffic Control$
Amt.of Deposit S
Total Due$
( )Cash O Check#
Applicant is responsible for contacting Paid By
the Police Dept.and C.R.Y.D.
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.
Of 0
Signed: Len=: ' Date: -`- Z-6-y ,. 1C4
Title:.C—C) tJ :S)L—(L-u CIV / J A) 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 08REV 10-22-08
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