HomeMy WebLinkAboutStreet Cut Permits 151 Pleasant Valley R (2) 1400196 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 07/07/2014
GIS ID: 72900151 - - FEE: 0.00
MUNIS APPLICATION# 201400892 EXPIRATION DATE:
APPLICANAT LOCATION
NAME: METROPOLITAN DISTRICT ADDRESS. 1PLASANT VALLEY ROAD
ADDRESS: 125 MAXIM ROAD O�UNER 4AL,AhINI CHRISTOPHER M
HARTFORD,CT 061 1fLSANT VALLEY ROAD
= SOL7TTI INDSOR,CT 06074
PHONE
WORK DESCRIPTION: RET%AfE HYDRANT-O 5fF
6081$2 - ==
APPLICANT AGREES TO FURNISH THE TOE OF SOUTH INDSf?R THE AMOUIVTI?F$AND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A -Y 1 XPEN SESINCURRED BY THE TL3 AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMILIAR WITH A WALL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN CIF S6IJTH�VINDSR---S=STREET-CUT PEIt1VIIT MANUAL.
ISSUED B DATE IN INSPECTED BY
7n12014 10:49 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR:
LOCATION: f�I ' � -1),41/Yr'a
TYPE OF WORK:'CiO la C���G"j��.r? �" w/D
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: B
WORK IN
PROGRESS: .
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES [:] NO
AS-BUILT:
INPUT: L`M DATE:
S/2014 Town of South Windsor INPSECTION REPORT 14
MD-039,Rev 2112 THE METROPOLITAN DISTRICT- PAVEMENT CUT DATE:
ADDRESS... __..0.`Y� �i :£z4 N/ - 1��II��,...-. j� BILL JOB D YES'.. 0 WO#..
CLOSEST STREET V i TOWN STATE HIGHWAY DYES .�' 0
DRAW SKETCH SHOWING LOCATION AND SIZE Ot CUTS AND OUT MADE IN
CROSS SECTION OF PAVEMENT
❑STREET DBITUM. " DCONC. OPREMIX----!'
❑SIDEWALK LIBITUM. ° ❑CONC. " }FLAG
❑CURB DBITUM. ' ❑CONC._' STONE_'
DDRIVEWAY ❑BITUM. ' D CONC. "
BASS LOAM&SEED NEEDED D YES A4,K) �
REASON FOR CUT:
DEPTH OF EXCAVATION:
8
NUMBER OF CUTS: I
DATE OF FIRST CUT: A a 0 _ q
IS JOB COMPLETED.: J;? ES/� ONO
FOREMAN: CJ yw
.REPLACEMENT PAVEMENT CONTRACT NO.:
BITUMINOUS ❑ CONCRETE❑ PREMIX D
i DATE COMPLETED,
ACCOUNT NUMBER:
CALCULATIONS
Na
I OF CUT ITEM# ITEM# ITEM# Tt EM/t
IPESS HARD 3 COPIES PAVINGINSPECTOR CONTRACTOR
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