HomeMy WebLinkAboutStreet Cut Permits 18 Spinners Run (3) 1400096 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/01/2014
GIS ID: 84200018 FEE: 25.00
MUNIS APPLICATION# 201400482 EXPIRATION DATE: 05/01/2015
APPLICANT K. ," LOCATION
NAME: ADVANCED CONS'IFAUCTION ADDRESS: 18'SPI INERS RUN
ADDRESS: 5 CHESTNUT HILL :C Ab OWNER. AD.DOI A JOSEPH&RUBINA Z
STAFFORD SPRIN S T b6676" 1$ SF'II IERS RUN
,SOUTH WINDSOR,CT 06074
PHONE 860-519-8442
WORK DESCRIPTION: INS TA-101 REPLACE CATV
APPLICANT AGREES TO FURNISH THE"TOWN OF SOUTH WINDSOR THE AM OT NT -F BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY=EXPENSES INCURRED BY THE TOWI1 FOK MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TI4E APPLICANT IS FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSR'S STREET CUT PERMIT MANUAL.
ISSUED BY DATE . ,.SPECTED INSPECTED BY
5/1/201411:01AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: `�O®D CONTRACTOR: Vaymed (oasy. Le}�9/ 'C�/.J
LOCATION: A(J)0f7p S gun
III
TYPE OF WORK: a I�.il, (��JlW CITL
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: g�
WORK IN
PROGRESS: � o
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C DATE:
S/2014 Town of South Windsor INPSEMON REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00 61 c�
Name of Firm '�Gy� V�-.�n (P�. �r�r1 S i 11e F,>7� V_� _Phone No.
� 5i t /
Address of Firm C,_Ch C—<X4 rid- h;x �4tir -f- Zip Code
Location of proposed work
Describe fully nature,of permit requested
I S P l��Pry !2(4 r1
Starting date /� Approx. time for completion
Call Before You Dig No. e�11/4 J��0 7S3 Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No. cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ Isf
Est.Patch Cost$_._,__.
Est. Curb Replacement It
Est. Curb Unit Price
` Est.Curb Cost$
-- Est.Traffic Unit Cost$ _ _/hr
Est.Traffic Control$
Amt.of Deposit$
Total Due
( )Cash ( )Check#
Applicant is responsible for contacting Paid By!_
the Police Dept.and C.B.Y.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 OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: 21e //�llti'v.�
Date: S4 Title: Driver's License#:
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08