HomeMy WebLinkAboutStreet Cut Permits 127 Rosemary Lane (2) 1.400124 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 05/20/2014
GIS ID: 77400127 ;
MUNIS APPLICATION# 201400604 = FEE: 25.00
EXPIRATION DATE: 05/20/2015
APPLICANT LOCATION
NAME: TELE-NETWORKS
1DDRI � 1 27 RfSEMARY LANE
ADDRESS: 31 BAKEWELL COiR �
Zk—
NR ITISSAI JKA SRIMATHIE L TRUSTEE
CRASTON,RI 0292 - �1OEMARY LANE
PHONE 401-461-8420
� L1P1I WINDSOR, CT 06074
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WORK DESCRIPTION: INSXXAL� RERE
APPLICANT AGREES TO FURNISH THE'TO} J Ou SOiL3' N1JKAI II AM Ifs AND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AIIXPEII;rES INC[� I MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TI 'Pa WANT I AI ILIA WTI A I L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TO WN CIF SOUTH W 3Sgt- G JT=p IT MANUAL.
of
ISSUED BY
DA`I` TNI'ECTED INSPECTED BY
5/20/2014 10:30 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /`-I()4 l(4 q CONTRACTOR:T-(�
LOCATION: /,2 7_4`-
TYPE OF WORK: 1�1_S- I �Taa la ce (-A-1-V
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: 8D
WORK IN
PROGRESS: ,f,4TV
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C,VV\"_. DATE:
S/2014 Town of South Windsor INPSECRON 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 $25.00
Name of Firm — -e-14 e-k W off- s Phone No. 1 9'4�- 2_�o 2-
Address of Firm 1 Cdc(" w6AA Ffo"jAlencp yx Zip Code 0&�k O 3
Location of proposed work 7•-10 R, 01.41-1 t
Describe fully nature of permit requested l 11 S' L�l �(' G� Cad T V
Starting date Call Before You Dig No 9C10/?0 367V
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: X No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
14 Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
See }-ktzine rf
0 Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est. Patch Cost$
Est. Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est. Sidewalk Replacement sf
Est.Sidewalk Unit Price$ /sf
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt. of Deposit$
Total Due$
Applicant is responsible for contacting the Police Dept.and C.B.Y.D ( ) Cash ( ) Check#
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 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
WINDSO 'S STREET,. PERMIT MANUAL. ///I
Sign Print Name'. U tom' vvve Sr k� �Gq 5`y1�'1'`f
Date:
reet Excavatio Permit 2014
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