HomeMy WebLinkAboutStreet Cut Permits 8 Windshire Drive (2) 1400119 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/20/2014
GIS ID: 95100008 FEE: 25.00
MUNIS APPLICATION# 201400598 = EXPIRATION DATE: 05/20/2015
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APPLICAI�k LOCATION
NAME: TELE-NETWORKS ADDRE I HIRE DRIVE
ADDRESS: 31 BAKEWELL COI Al R'I WILLIAM M&OLGA A
CRASTON,RI 0292 IS DRIVE
, DTI WINDSOR,CT 06074
PHONE
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401-461-8420 i
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WORK DESCRIPTION: IN§�A I A
APPLICANT AGREES TO FURNISH TH1T0) Ok SOUTHIII� IAMD(NT O 1ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A V:kPR1�1 I S Ii<iLI.R I & IH 3�WI FOI MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND ThE XPPLICAI T I FA I�kR WITH A R I L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN CIF SOTJ H NDISR� nTR EI JT PFI MIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
5/20/2014 9:22 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: LI®® / CONTRACTOR: ��' G"
LOCATION: f A e n As h.l cf' m nY W&6,
(A)i P(ash 1 rye tv "�
TYPE OF WORK: h5 a I / �)aL,P C/-}-1' y
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: �
WORK IN
PROGRESS: Aj'e4Qbrk,,e ;r,fcn
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.
ATOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00
Name of Firm � e-1�f' ^Off 5 Phone No. 0 Y'4�- 2-�Co)Z
Address of Firm- Ffo"jickencp VS Zip Code 0&A03
Location of proposed work r F- AkbeAP b .& ye �v 9v -1
Describe fully nature of permit requested
Starting date .5/44;Ldy Call Before You Dig No a�l'1/y0 3696
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: X No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
5Q Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
See A Pecc heG,) 0 Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est. Patch Cost$
Est.Curb Replacement ft
Est. Curb Unit Price$ /ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price
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
WINDSOR,S STREET PERMIT MANUAL. f'
Sianeder" °`�` Print Name, Y� St {\/\ �G1 Date:
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