HomeMy WebLinkAboutStreet Cut Permits 9999 Ellington Road (2) 1400162 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 06/11/2014 vti
GIS ID: 99993030001
- �T FEE: 0.00
MUNIS APPLICATION# 201400748EXPIRATION DATE:
APPLICANTy = LOCATION
NAME: METROPOLITAN DISTRICT - ADDRMS. 99 ULINGTON ROAD
ADDRESS: 125 MAXIM ROAD �NEF2 'FAWN F SOUTH WINDSOR
HARTFORD,CT 06 1}� 15rt�L ,LIVAN AVE
OR, CT 060742734
PHONE =
WORK DESCRIPTION: REIALE - - IG ( Rp' O-WEST OF PIERCE RD
W/Off81$7 �
APPLICANT AGREES TO FURNISH THE'TO J Q� SOUIItgW_3 "AM9 1Tg I ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AItY EXPENSES I1CTIFR TEE T ? J3I FIJ131vIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TFI API ICANT IS FAIt�1 AR VVTH A2 WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN F___§ 7 H WIIVDSI f=STR ET'CU I 3'1 41IT MANUAL.
ISSUED BY DAIETMECTED INSPECTED BY
6/11/2014 10:52 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: '1 DD CONTRACTOR: Al DC,
LOCATION: E l ljh�tbh Load Md'we:'Y egi( &nec e i'ead
TYPE OF WORK: CeaImc&- e-'k t"If
DATE INSP NEEDED: DATE INSP: 2110 I f y
INSPECTED BY: b
WORK IN
PROGRESS: � 01A Ot�Q
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/2014 Town of South Windsor INPSECTION REPORT 14
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 $25.00
:::.:.:::.:::::: :....,:.:..::.
Address of Firm 17.5 MAY—tAnk o Zip Code 06
Location of proposed work W 0 a o
Describe fully nature of permit requested
if( LAC ()a rwr 10 AANY w0 ,576 0 8'1 J'7
Starting date E 0"I Call Before You Dig No a.01 I a 3 0 4 31 7
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut K Pavement Cut K Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: h Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be fill led out by Town
two copies of separate drawing
0 No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /it
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$ !sf
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffle Unit Cost$ Ar
Est.Traffic Control$
Amt.of Deposit$
Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting the Police Dept.and C.B.Y.D
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 A EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND
THAT I AM FAMI R WITH ILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR' Cit
P AL.T .{ �j n t�
Signed: Print Name )o H r" ' " _ "t(/Q Date: 0`10 v
Street Excav on Permit 2014