HomeMy WebLinkAboutStreet Cut Permits 9999 Ellington Road (3) 1400197 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 07/07/2014
GIS ID: 99993030 FEE: 0.00
MUNIS APPLICATION# 201400893 EXPIRATION DATE:
APPLICAN gq ot LOCATION
NAME: METROPOLITAN DISTRICT - ADDRESS. - LINGTON ROAD
ADDRESS: 125 MAXIM ROAD; TOWNF SOUTH WINDSOR
HARTFORD,CT 06 14# - I1f SUS LIVAN AVE
x �Vi1DOR, CT 060742734
PHONE
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WORK DESCRIPTION: REPtL E M- NT V/O 561 81$4
APPLICANT AGREES TO FURNISH TRITON OFOUTI�WII*1DSgR THE AMONT� BAND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A13IYXFENSES INCURREDB-THIt`t'OWI FDIvIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE AZ'FLICANT ISrFAMMIAR WJ*fi AND W 1 L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN-C3F SOUTH WINDSR SS3 REST CUT P1 ICI IIT MANUAL.
ISSUED BY DATE INSPECTED INSPECT D Y
7/7/2014 10:53 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: LlWli7 CONTRACTOR: m be
LOCATION: /? S1ld CairOer Pare,Oiec ) bl j u-e-
TYPE OF WORK: (19p�afPl
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS: o'--�-
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:_
S/2014 Town of South Windsor INPSEMON REPORT 14
MD-039,Revaiz•`" THE METROPOLITAN DISTRICT- PAVEMENT GUT DATE: —2ott.4
ADDRESS �'4/ro49 �� .JY "0,4. P AVLEIA) OR BILLJOB p_YESti
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CLOSEST STREET a ct-k V -eo 0 TOWN-5 (,D i STATE HIGHWAY.❑YES 5Q NO
DRAW SKETCH SHOWING LOCATION AND SI E OF CUTShND CUT MADE IN
CROSS SECTION OF PAVEME1 IT IV
la ❑STREET ❑BITUM. " ❑CONC._" ❑PREMIX"
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❑SIDEWALK ❑BITUM. " ❑CONC. ❑FLAG
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6.o C ❑DRIVEWAY ❑BITUM.�" E7 CONC.01, :.
W 4GRASS LOAM&SEED NEEDED' ❑YES 4 NO
REASON FOR CUT.
DEPTH OF EXCAVATION: S~
NUMBER OF CUTS: U
i r DATE OF FIRST CUT: C - 2 4/
I ry Uti 2 IS JOB C D; YES ONO
FORE AN: � !o Q rt-c a o
E T PAVEMEN CONTRACT NO,;
BITUMINOUS ❑ CONCRETE❑ PREMIX❑
DATE COMPLETED:
ACCOUNT NUMBER:
CALCULATIONS
OF CUT ITEM# ITEM ITEM ITEM# ..
PRESS HARD 3 COPIES PAVING INSPECTOR CONTRACTOR
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