HomeMy WebLinkAboutStreet Cut Permits 48 Sele Drive (2) 1400246 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 08/14/2014
GIS ID: 81800048 FEE: 0.00
MUNIS APPLICATION# 201401120 - EXPIRATION DATE:
APPLICANT ,, LOCATION
NAME: YANKEE GAS ADDRESS: 48 SELF DRIVE.
ADDRESS: 112 PROSPECT HILL RIB OWNER --MJREK I ONALD J&CAROLYN T
EAST WINDSOR, C Q_688 - 48 SIT ERNE
1LJUPIIVINDSOR,CT 06074
PHONE 860-292-2242o
WORK DESCRIPTION: INSTAL •_NErW GAS-SERVICE
APPLICANT AGREES TO FURNISH THE TOW}--1 OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANC'-I�7{P$NSES-INCURRED$Y THE.TOWNOR MAINTENANCE OR REPAIR WORK IN
IA
CONNECTION WITH THIS PERMIT AND Tli AP LICANT IS FAMILR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN O SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
ISSUED BY DATE INSPVCTED INSPECTED BY
8/14/201410:58AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: J L/ 06,;2 CONTRACTOR: �Ap"Ay-e p
LOCATION `-, , S I e ►�. r w-
TYPE OF WORK: V-)e-,"3 S-eAv
DATE INSP NEEDED: DATE INSP: j aI ► )i y
INSPECTED BY: -Fb
WORK IN
PROGRESS: 6 -/0 cle r
i�
/fie
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C 'i� DATE:
SJ2014 Town of South Windsor INPSECTION REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: 7
SOUTH WINDSOR,CT 06074
FEE $25A0
Name of Firm !�1 Phone No.
Address of Firm I/ ,// Zip.Code C�Spp,
Location of proposed work�,l�_ n-r
Describe fully nature of permit requested .Lec�
Starting date '%—" Approx.time for completion
Call Before You Dig No.6100'120a375 Existing Water Supply: ❑ Public Wafer ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
tENGTIi�TRA FiCGONTROL AND TFIE 7{�WN'R GpNTRAGT LISTS THE-PERMANENT-PAT(sH-IS-TYPICALLY
COMPLETED WITHIMA YEAR OF THE TEMPORA[3Y PATCH BUT IT COULD BE LATER THAN A YEAR-. `
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing48 Indicate North Town of South Indsor
No.cuts
Est.Patch Size(s) sf
1 Est.Pvt:Thickness in.
1
Est.Patch Unit Price$ /sf
I Est.Patch Cost
Est.Curti Replacement-it
I
I Est.Curb Unit Price$ /{t
� Est.Curb Costey $
Est.Traffic Unit Cost$ /hr
L
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: 4,:,. C� o+ti zea , Date: 6'4 y
Title: C 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 10-72-08
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