HomeMy WebLinkAboutStreet Cut Permits 35 Summit Drive (2) 1400027 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 02/13/2014
GIS ID: 87800035 FEE: 0.00
MUNIS APPLICATION# 201400134 = "EXPIRATION DATE: 02/13/2015
APPLICANT LOCATION
NAME: YANKEE GAS ADDRESS; 3 SUMMIT DRIVE
ADDRESS: 112 PROSPECT HILL Rff` OWNER: BIAN&RDI STEPHEN R AND DONNA A
EAST WINDSOR, 35UNIMIT DRIVE
SITIVWINDSOR,CT 06074
PHONE 860-292-2242
WORK DESCRIPTION: EXd;AMATE TO"IYIOLE UNDER STREET FQR GAS SERVICE
APPLICANT AGREES TO FURNISH THI TOWN OF SOUTH_WINDSOR'THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A EEXPENSES INCURREI3 BY THE TOWN FOIE MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND T APPLICANT IS FAMILIAR WITH 4I L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOOTH WINDSR'S S TREE TCUT--PERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
2/13/2014 8:56 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: �'�(�(�Q, : CONTRACTOR:Mn,n �Qv
LOCATION: �_� ��w_.mM�`� "L>r w-e
TYPE OF WORK: S&Q�Ce "160 t Z
DATE INSP NEEDED: DATE INSP:�
INSPECTED BY: eb
WORK IN
PROGRESS: ,S Q ✓; �. a,r�A
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: L � DATE:
S/2014 Town of South Windsor INPSEMON REPORT 14
Lc+ cc-- 4- APPLICATION FOR TREET EXCAVATION(
4- i T A ONtPERMIT 14cccZ�
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1640 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
*6o6;p6 FEE $25.00
Name of Firm Phone No.
Address of Firm 1 2: �,(L ® PCQ` jj (l Zip Code 6 C �
Location of proposed work 3 5 C(A IM M 1 Ti" D if-.
Describe fully nature of permit requested 2�C 1� '' M 0 L.C G t#cY SX it Vl C&c
(L ID M 6 C t2 0 .sS G' If if S z�- ;2-4Cc�r
Starting date Approx.time for completion
Call Before You Dig No._-ot �2,7 do 67.3 Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT;INCLUDING.ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
_i
two copies of separate drawing Indicate.North Town of.South Windsor
i No.cuts
f
s Est.Patch Size(s) sf
5 Est.Pvt.Thickness in.
I Est.Patch Unit Price$ /sf
I
i
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
:i
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est'.Traffic Control$
.5uMra (` -
Amt.of Deposit$
Total Due$
CD3 ( )Cash ( )Check#
Applicant is responsible for contacting G O'S Paid By
the Police Dept.and C.BY.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 OUT/LINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: ��'"" Date:
Title:.L' C) JJ 3 A) Driver's License M
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED
PER._MIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08