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HomeMy WebLinkAboutStreet Cut Permits 20 Sele Drive (2) 1400262 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 09/03/2014 GIS ID: 81800020 FEE: 0.00 MUNIS APPLICATION# 201401231 EXPIRATION DATE: APPLICANT = - LOCATION NAME: YANKEE GAS = ADDRESS: 20-----SELt DRIVE ADDRESS: 112 PROSPECT HILL RD _ OWNER: LARSA KENNETH A&BARBARA&BAS EAST WINDSOR, C'f- 0 20LEDR SOUTH`9VINDSOR,CT 06074 PHONE 860-292-2242 WORK DESCRIPTION: ROAD©�ENING`FOR-GAS SERVICE / APPLICANT AGREES TO FURNISH THEVOWN OF SOUTH WINDSOR THE AMOUNT OFI*D REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANY 13�PENSES INCURRED BYTHE TOWN"FOR-MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMILIAR WITH AND WALL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN 6F SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. )) % ISSUED BY DATE INSPECTED INSPECTED BY 9/3/2014 12:12 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: /!J C0,2 L �- CONTRACTOR: a.rn U LOCATION.--.,_. D .. - 12a'i v41-_ TYPE OF WORK: Ili DATE INSP NEEDED: DATE INSP: 17 INSPECTED BY: WORK IN PROGRESS: SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: 0 INPUT: DATE: �� S S/2014 Town of South Windsor WSEMON 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 $25.00 Name of Firm 7 r\ e e I q1 S Phone No. 9 b o-9(0&- 99 i q Address of Firm__An cn Lc. aS# Wiv,�SOr , . Zip.Code_o.&069 Location of proposed work S0-Vev\ V)1� t r Describe fully nature of permit requested 1'�cad n��n i�q .�r �aS (Cr vi Le- Starting date A-r>N,1 Approx.time for completion_ S Call Before You Dig No. -LO14 Existing Water Supply: ❑ Public Water ❑Well Existing Sewage Service: ❑ Public Sewer ❑Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA,CURB tENGTfi;-TRAFFIG-CONTROL-AND-T-HE-TOWN-S-GONT-RAC-T-C-OSTS� THE-PERMANENT-PATCH-IS-TYPICALLY COMPLETED WITHIN•A YEAR OF THE TEMPORANY PATCH BUT IT COULD BE LATER THAN A YEAR. ` Show sketch of proposed work or furnish This section to be filled out by two copies of separate drawing Indicate North Town of South Windsor No.cuts 2-0Est.Patch Size(s) sf Est.Pvt:Thickness in. Est.Patch Unit Price$ /sf i Est.Patch Cost Est.Curb Replacement ft 4I j ,s Est.Curb Unit Price$ /ft I Est.Curb Cost$ Est.Traffic Unit Cost$ /hr i Est.Traffic Control$ Amt.of Deposit$ Total Due$ L .' 2"YL Ike )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:!/ — — C.A ��bti /,t. -�il'- Date: 't 7 Title: r r�T,'yv` 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 A +'J