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HomeMy WebLinkAboutStreet Cut Permits 74 Edgewood Drive (3) 1400152 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 06/10/2014 = S 74 ,. GIS ID: 29400074 " FEE: 0.00 MUNIS APPLICATION# 201400733 EXPIRATION DATE: !� LOCATION APPLICANT y NAME: METROPOLITAN DI TRICT - ADDRE$5 /�4�91)13EWOOD DRIVE %�� ADDRESS: 125 MAXIM ROAD , � � �y� .��1 PTIJLIPVIRGINIA M HARTFORD,CT 0614 4TSCrWOOD DRIVE y y (�L�FU�VINDSOR,CT 06074 PHONE !% — d WORK DESCRIPTION: REMAKYWkY �� 3 APPLICANT AGREES TO FURNISH THEE O i 0-- SOUTH �'An4Q; T�F BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR AMAPEiVI1SlItIYJI31 FHE TQORRGIAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND TIt Aftiic' T I 'A TAB V I AI D WALL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OESW%RWIND I :ST ET CDTPEIfiIIT MANUAL. ISSUED BY DATETED INSPECTED BY 6/10/2014 8:15 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: L/©® I f q CONTRACTOR: M PG LOCATION: 7 y eol!q e wg®d Or i V e Flo TYPE OF WORK I y r Ei rp DATE INSP NEEDED: DATE INSP: INSPECTED BY: WORK IN PROGRESS: L , '0- SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: (4 S/2014 Town of South Windsor INPSEMON REPORT 14 MD-039.Rev 2/12 THE METROPOLITAN DISTRICT PAVEMENT CUT DATE:_— ADDRESS C C�1 BILL JOB __.. __YVO1_.�. n1�" T CLOSEST STREET,----:— 1 i Z j6P'�r� 137 TOWN �. G.1 r,ij o R, STATE HIGHWAY ❑YES AO DRAW SKETCH SHOWING LOCATION AND SIZE OF CUTS AND I CROSS SECTION OF PAVEMEN x CUT MADE IN '•k r P,,<TREET 0 BITUM._,�" ❑CONC. " ❑PREMIX_" 3 ❑SIDEWALK ❑SITUM._' D CONC. ❑FLAG " URB 1TUM._'_ ❑CONC.-' D STONE ' DDRIVEWAY ❑BITUM.-" ❑CONC. " �,RASS LOAM&SEEEED�NEEEDED []YES NO REASON FOR CUT f2e ACED GuCCAE ° v z a DEPTH OF EXCAVATION: Of NUMBER OF CUTS: ( ` DATE OF FIRST CUT: / IS JOB COMPLETED; 01ES ❑NO FOREMAN: 10.11� REPLACEMENT PAVEMENT CONTRACT NO.: 01 BITUMINOUS ❑ CONCRETE❑ PREMIX❑ DATE COMPLETED: ACCOUNT NUMBER: C CALCULATI NS OF CUT ITEM# ITEM# ITEMS ITEMS � PRESS HARD 3 COPIES PAVING INSPECTOR CONTRACTOR w, (ORGINAL) (YELLOW)