HomeMy WebLinkAboutStreet Cut Permits 9999 Ellington Road (4) 1400160 TOWN OF SOUTH WINDSOR CT
PERMIT NUMBER ,
STREET CUT PUBLIC UTILITY
DATE: 06/I1/2014 ,.
GIS ID: 99993030
MUNIS APPLICATION# 201400746 FEE: 0.00
EXPIRATION DATE:
APPLICAM-
NAME: METROPOLITAN DITRIC3 LOCATION
ADDRESS: 125 MAXIM ROAD
ADDRH�S 99`99 9LLINGTON ROAD
= � IOWNF SOUTH WINDSOR
HARTFORD,CT 061� -50
1fSLLIVAN AVE
PHONE i = I OR, CT 060742734
��
i
WORK DESCRIPTION: RE �AE � IN fVCORNER PARKVIEW DR
W/ sIlu
APPLICANT AGREES TO FURNISH THMTOWN OF OV IL
THE TOWN OF SOUTH WINDSOR FOR AXP12�IES I1 g pp �DREQUIRED AND TO
N
OR REPAIR WORK E
CONNECTION WITH THIS PERMIT AND T A0I' I ALIT ISTA AR W ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN SQTJTII WII DSJWA--TR B� JrP1 IT MANUAL.
ado/ av
ISSUED BY DAE�TED INSPECTED BY
6/11/2014 10:40 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
Jr
%„
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I Y60/doh CONTRACTOR: /yl-DG
LOCATION: 1° /1
TYPE OF WORK: g��sting 4 k V dran-r
DATE INSP NEEDED: DATE INSP: id. w it
INSPECTED BY: 9b
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: 1
S/2014 Town of South Windsor INPSEMON REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,GT 06074 FEE $25.00
Name of Firrn t � NO of (lrn f & r _._ .... _
Phone No. '� 0� �7�j-
Address of Firm 2 5 d Zip Code !
Location of proposed work r;lr IN A A
Describe fully nature of permit requested
ACC r~ 15 N 56(9 f a
Starting date------ 1-0- ( Call Before You Dig No as I Yq 3
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut -?f Pavement Cut A'Curb Cut E1 Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish two copies of separate drawing Indicate North This section to be filled out b Town
0 No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$ /sf
Est.Sidewalk Cost$-
Est.Traffic Hours hr
Est.Traffic Unit Cost$ mr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
Applicant is responsible for contacting the Police Dept,and C.B.Y.D ( )Cash ( )Check#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Paid By
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH
WINDSOR FORA Y EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMITAND
THAT!A AR AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDS 0 IS E M AL.
Signed: Print Name �" `� I,V f`I Date: 0-10 ' t
Street Exta 'on Permit 2014