HomeMy WebLinkAboutStreet Cut Permits 144 Griffin Road (2) 1400298 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 10/02/2014
GIS ID: 39000144
MUNIS APPLICATION# 201401405 FEE: 0.00
PIRATION DATE:
APPLICANT: LOCATION
NAME: YANKEE GAS ff
ADDRESS- 1-44JORIFFIN ROAD
ADDRESS: 112 PROSPECT HILL RD OWNER -BEiSOA ADAM R&PAULA A
EAST WINDSOR, CT 06-098 = 14 RI FIN ROAD
PHONE 860-292-2242 = TH INDSOR,CT 06074
WORK DESCRIPTION: INS'fhLI.d- S RVIC1
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY IPENSES INCURRED BY TIIE TgWN FOf1INTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND T1f ,APPLICANT IS FAMII I-AR WITH AFIIJ WIBI`ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF-SOUTH WINDSOR'$STREET CU I I'EIMIT MANUAL.
ISSUED BY DATE IIN=.PELTED INSPECTED BY
10/2/2014 9:16 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I/-/0OR 9 fj CONTRACTOR:!aC4 a
PIN LOCATION: 9 I'� {'�i ti ePa��
TYPE OF WORK:_ ills to ll !h ,.m � Vice
DATE INSP NEEDED: DATE INSP: / Az
INSPECTED BY:
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT:` DATE:
S/molloy/forms 2014 Town of South Windsor INPSEC71ON REPORT 14
09/25/2014 THU 15: 38 FAX 860 292 2202 0002/002
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: 5-/4/
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm an Le P G 0,5 Phone No. 8(oV 3 3S-5.�81
Address of Firm a- C Zip Code CG OS R
Location of proposed work
Describe fully nature of permit requested__kn A-GLkk QQ.,) S=Qrv1 CA—
Starting date as Q4 Approx.time for completion
Call Before You Dig No.dU(L(3 90,2 u70 Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est. Patch Size(s) sf
L
Est.Pvt.Thickness in.
p5 e c1 Est. Patch Unit Price$ !sf
u 5�0 Est.Patch Cost$
c r CA-
b I Est.Curb Replacement ft
v I Est.Curb Unit Price$ /ft
8 She I Est.Curb Cost$
Gn-��n 2dk Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
KO �0�� �, _ Total Due$
1 QL.I (\ )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: � Date: q-a5-/L1
Tftle: l-0n 3+aic J z t!0 i1 Tech 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