HomeMy WebLinkAboutStreet Cut Permits 9999 Avery Street (4) 1400151 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 06/09/2014
GIS ID: 99990630 N„ FEE: 0.00
MUNIS APPLICATION# 201400729 = EXPIRATION DATE:
66
APPLICAI� - - ,
LOCATION
NAME: YANKEE GAS ADDRW 999 EERY STREET&BEEZLEBUB RD
ADDRESS: 112 PROSPECT HILL R �� � TOWN j)F SOUTH WINDSOR
EAST WINDSOR, C-'i.0-0& % iM#YS ILIVAN AVE
%ODOR, CT 060742734
PHONE 860-292-2242 ;
lb
WORK DESCRIPTION: TETIF� EI�rtC1YIfS3� SEI1 DRAINAGE&ROAD
CU' ERNt 1R.
APPLICANT AGREES TO FURNISH THftO N OF Oi�3'II �E AMOK I�DF 13aND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AIII XPI NOES INGCJ.RR3 THE,TOWIFOI�vIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE A-PPLN&T IS}#AI�I M Vet H I WIC L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TO WN bE S(TJH WTN3?Sl' TR2 ET GT'PILIIT MANUAL.
ISSUED BY DA' E PELTED INSPECTED BY
6/9/2014 11:42 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
6 p-
-24
-3229
i ,
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: F—
LOCATION: ' f C�t° S '�P �- 1 �� i F, c t� Re)
TYPE OF WORK: " e.s a Zelidil
DATE INSP NEEDED: DATE INSP: r2- I� It
INSPECTED BY: 6
WORK IN
PROGRESS:__ _fc
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: Chi DATE: I
S/2014 Town of South Windsor INPSECTION REPORT 14
i
APPLICATION FOR STREET EXCAVATION PERMIT
Appl.No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00
Name of Firm Yck*-ea- 64s Phone No. 536�•-24z-22t9
Address of Firm 1 1 Z C-7- Zip Code 0(o 07,6
Location of proposed work PtyI-Cu4 5--
Describe fully nature of permit requested
Starting date Call Before You Dig Not 11f 1,�40U
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service, ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
w \ No.cuts
Est.Patch Size(s) Sf
Est.Pvt.Thickness in.
Est.Patch Unit Price
\ Est.Patch Cost$
v
Est.Curb Replacement p ft
I \ Est.Curb Unit Price$ /ft
r^� Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$ /sf
G
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
V,1 Amt.of Deposit$
fl Total Due$
(Applicant is responsible for contacting the Police Dept.and C.B.Y.D )Cash OCheck#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Paid By
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 1 AR WITH AND ILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSO TR T CUT MANUAL.
Signed: Print Name r' 1��1 1 Date: 6A*11'f
Street Excavation Permit 2014