HomeMy WebLinkAboutStreet Cut Permits 9999 Chapel Road (5) 1400153 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 06/10/2014 - = ,
GIS ID: 99991800 = FEE: 0.00
MUNIS APPLICATION# 201400734 P.IRATION DATE:
th
APPLICANT C LOCATION
NAME: METROPOLITAN DIiTRICT- DDR*,, CHAPEL ROAD
ADDRESS: 125 MAXIM ROAD
ft7 %WN bF SOUTH WINDSRO
HARTFORD,CT 061
'�1S4if�U' ,LIVAN AVE
jjw,AS % �QiJ`I'H WINDSOR,CT 06074
PHONE
WORK DESCRIPTION: REPS ACE I� YIOA3 c4 CI �L ? N
APPLICANT AGREES TO FURNISH THE TOE OF SOUTH T flSf?I IF f1M(VAN- bF BAND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AIRY P N ESTV tI I I. THE IO - IrOI v1AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND Tl AAPI I ALj1 IS I`AI CI t W T I AID WAL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINE/D��IN THE TOWN SEWWr CUT PE vIIT MANUAL.
ISSUED BY `P -UTED INSPECTED BY
6/10/20148:21AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
oW-
-
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /Y001 CONTRACTOR: M 160
LOCATION: a6a
TYPE OF WORK: ®l a_rL✓ nT 1�j '' Sri S 8 1
DATE INSP NEEDED: DATE INSP: 6
INSPECTED BY:
WORK IN
PROGRESS: +
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: L DATE:
S/2014 Town of South Windsor INPSEMON REPORT 14
MD-039,Rev RM2 THE METROPOLITAN DISTRICT- PAVEMENT CUT DATE: �s�•''-'/`� ..
ADDBESS / �? � � BILLJ08 ❑AYES E3 P415 WO#. .. 1 v. /� 1._:.
CLOSEST STREET TOWNOQ:.,—STATE HIGHWAY El YES C31Q6
DRAW SKETCH SHOWING LOCATION AND SIZE OF CUTS AND
CROSS SECTION OF PAVEMENT /S l CULT MADE IN
W-81 REET 9-16 T�UM.�❑CONC.T" 0 PREMIX_—'
❑SIDEWALK ❑BITUM. " ❑CONC. " ❑FLAG
\ J C eull18 aBrTIUM.-._. 7- ❑CONC. ❑STONE '
\!U ❑DRIVEWAY 0B1TUM. " ❑CONC "
MASS LOAM&SEED NEEDED ❑YES p•N0'
'Till/
/
REASON FOR CUT ±
DEPTH OF EXCAVATION:_ e• g
\- NUMBER OF CUTS: l
r\�f DATE OF FIRST CUT:
1\J, IS JOB COMPLETED; EI-YES ONO
FOREMAN:
REPLACEMENT PAVEMENT CONTRACT NO.:
BITUMINOUS ❑ CONCRETE❑ PREMIX❑
DATE COMPLETED: _
ACCOUNT NUMBER: ice
CALCULATIONS
OF CUT ITEM ITEM# TE ITEM#
PRESS HARD, 3 COPIES PAVING INSPECTOR O(YELLOW)R