HomeMy WebLinkAboutStreet Cut Permits 45 Kelly Road (2) 1400189 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 06/30/2014
GIS ID:49500045 FEE: 0.00
MUNIS APPLICATION# 201400867 _ EXPIRATION DATE:
APPLICANT
LOCATION
NAME: YANKEE GAS DDRE 4�RE> Y ROAD
ADDRESS: 112 PROSPECT HILI,III ,
- ' L 9UTER GREGORY R&LAURIE J
EAST WINDSOR,C Q 8$
NO- -4 ROAD
ji
% sOIJHVINDSOR, CT 06074
PHONE 860-292-2242 _ ;
WORK DESCRIPTION: EXCAIISCrS� EtTI IN GRASS BEHIND
CUR3I>1�N3 RflADT
APPLICANT AGREES TO FURNISH THE TO ( OUTFL1$t?RI ILAMCIfiFfi I ?F BAND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANIXPET�II II<# URIS$3f)4TE 1 Q9I�vIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE AT- PLI T IS. ft-WR l4o ADD WF L ABIDE BY THE RULES AND REGULATIONS
,FOR PERMITS AS OUTLINED IN THE TOWN SOUGH�yINDSR ,TREE I GUT PEIIIT MANUAL.
ISSUED BY D4TE SPECTED 1 INSPECTED BY
6/30/2014 10:37 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
--------------------------
-----------------
44
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: v/ CONTRACTOR: LJ
LOCATION:
TYPE OF WORK: /I.
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: I'D
WORK IN
PROGRESS: slay - C ,�t s . s O lLe C Vj s S e 1-VkQ- 7LZI
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: � � DATE:
S/2014 Town of South Windsor INPSEMON REPORT 14
/�1 �1 �iAT1l3R `TTX+ �4 /ATflN P #�l� T
A pt No TO WORM TH�III�II;�ROR l errnit No:
PUELIC ORKS®EPARTMENT
54 $UL_L utv i A1/E'NIjE Gate:
SOUTkI_A1#NRS(3R� 1`tJS074
-77
Fr2rJ.QQ
Name of��irm 4 - �e� V Grs C ,a� Ate;. Rhone Igo.
Address of rrtn 14 .'r® 4y s ti r-s' s Zip Code 4 l
L patlph of prap�sed work G ( : �- .:K'u tll7 �s ue.
bescr��e fialiy nature of permit Requested " �:
n f. �.. C., .'
a
Starting date `► rG. ,.APprox tam far aorle#ron �'r
Call Befare �u Did No { 2 O 19 ExiSfirtg W-Atar Supply P�ab(tc 1Na#er []Weil
Eic►;;i fig Sewage Service; [ Publtc Seger Septic
PLEASE NOTE. TF E DEPO;;IT;POR THE PERMANENT PAVEMENT PATCNAIVD CURB REE'LAGEMENT,lE.A_
RR1~LIAA�NARY E3TlINATE._THE APPLICANT IS I�ESPON$lBLE FOR SHE 1=UL'FIMA .COST.OF THE
PERMANENT PATiP.H AND CURB REPLACEMENT,INCLU.bING CREASES IN
PATCH'AREA CURB
LE151iaTH;T AFF10:CON7 RoL AIVp THE TO1NN'S Ct)NTRACT 0.-S :THE PERMANI=NT PATCH IS TYPICALLX
COMPLETED t"!fjiN A'YEAR 4F THE TEMPORARY PATCH EUT IT COULD BE L"ATER THAN'A YEAR.
-Show sketch of prdposedvork or famish
trvo copses of separate drawing This se�tlon to.be filled out by
Indicate North Town of South Windsor
u/.U, 0 C '2 F l 5`� No'=cuts
Ate- U Fit Patch Sizes) sf
Gi3 �( 2,U(' z U( Est.Pvt.Thtdcness in.
Est.Patch Unit Price$ !sf
5 e g PGQ Sko TC h Est Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ Ift
Est.Carp t:pst$
Est.Traffic Unit costs Mr
Est Traff[o Control$
Aint.ttf Depos[t
Total Due$
(,)Cash.-, O Check# ,
Applicant is responsible for contacting: Paid t3y.
the Polio De t.and CAlY.D.;`
1 AGREE TO FURN18H TO THE TOWN OF SOUTH W[NQSOR THE AMOUNT.OF BOND REOUIRED AND TO REIMBURSE THE
TOWN OF SOUTW WINDSOR FOR,ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPA9R WORK IN'
CONNECTION WITH.TNiS PERMIT AND THAT[ANt FAMILIAR WITH AND WILL ABIDE BY THE:RULES AND REGULATIONS FOR
PERMITS AS QUTLINED IN THE TOWN OF`SOUT14 WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: (0( Z
Title. 7 G t!'o r s `• �C`c Driver's Ucense#t
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OI~PERMIT
WORK MAY NOT BEGIN UNTIL A.PERMIT HAS BEEN ISSUED -
PERMIT-SHALL BE MOT ON*SITE AT ALL TIMES.
Street Excavation:Peririlt 08,PV 1642-08
s
KELLY RD.
----------
4 PE- P 2011
........................................................................................... ..... ....... ................................
317 'A
('A JV z I
E�l
45
CBYD Locate Request (Routine)
(CALL BEFORE YOU DIG - CT) 06/25/2014 17:31:13
1-5G YANK/G -AH -C1 -CW
-OT -SW -T5
Date: 06/25/2014 Time: 17:31
Request #: 20142603019 Prev. Request #:
Latitude: 41.8271920 Longitude: .-72.5153509
Address: 45 Street: KELLY RD Town: SOUTH WINDSOR
Nearest Cross Street: ELM ST
Type of Work: EXCAVATE TO INSTALL GAS SERVICE.
Area is Marked: YES
Remarks: WORKING FROM GAS MAIN BEHIND CURB LINE TO THE EAST SIDE OF HOUSE.
Start Date: 07/01/2014 Start Time: 07:00
Caller: MIKE HANECAK Call Back: 7:30-4
Phone Number: (860) 292-2247 Alt. Phone:
Fax #: 860-292-2269 Email:
Contractor: YANKEE GAS Excavator: YANKEE GAS
Address: 112 PROSPECT HILL RD City: EAST WINDSOR State: CT Zip: 06088
Were pre-construction marks visible? C❑Yes No
................................................ ........................................................ ......... ......... ......... ........ ......... ......... ......... ................................................... ....... ......... ............... ............
What facilities were marked? �C Main D Service ❑ Both
Main facility material type? ❑ Steel 1�4Plastic ❑ Cast Iron
........ . .. ........ ................................................ ......... ........ ........ ......... ......... ......... _ ...
Service facility material type? ❑ Steel ❑ Plastic ❑ Cast Iron
..............
How were the gas facilities located? Conductive ❑ Inductive Measurements
.... ......... ......... ......... ....... ......... ....... .......... ... ........
Where was the connection made? ❑ Meter Value ❑ Test wire in box Tracer wire on service [A Direct connect to pipe
Did measurements match the signal? XYes ❑ No What was used for measurements? �IS Service Card
..I..... ....... .. ......... ..... ......... ........ ........ .......... ........ ....... .......... ....................._..
How was the area marked? ❑ Paint ❑ Stakes CAoth
_._._._ m __,, „ ......... ....._. ..
Who was the site verbal contact? >A
... ................... .... .... .... ..... .... ......
Work completed by