HomeMy WebLinkAboutStreet Cut Permits 139 Kelly Road (2) 1400311 TOWN OF SOUTH WINDSOR
PERMIT NUMBER C T
STREET CUT PUBLIC UTILITY
DATE: 10/17/2014
GIS ID:49500139
MUNIS APPLICATION# 201401486 =" -" FEE: 0.00
EXPIRATION DATE:
APPLICANT - LOCATIONNAME: YANKEE GAS , CAD
ADllRE L39ELLy R
ADDRESS: H2 PROSPECT HILL IUD
QWWER CI,AUD&PINTALDI
EAST WINDSOR, CT 06g88
12 4O&ENDGE DR
PHONE 860-292-2242 - =: oLLAND, CT 06084
ik
WORK DESCRIPTION: EXCAVATE Yi�fiRAttEA�JF �, T O WAyT 4NSTAL
PLASTIC AS SERVICE_ L 1/2 IN
APPLICANT AGREES TO FURNISH THE PO WN OF SOUTH WINO OW AMOUNT OP BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INGSTRREI713yHR TOW3l FOR lvINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TH APPLICANT IS I AMILIAR WITI4ANL?WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OKS.,0U'TH,WINDSORsS S REE°I CUT I'E-WT MANUAL.
-- ,
ISSUED BY -
DATE SP C "ED INSPECTED BY
10/17/2014 12:36 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: q00,311 CONTRACTOR:,
LOCATION: 1 ,39 k e i l u �O r�-
TYPE OF WORK: ar&% G�l3 cJ, ifiom l r �l �fG� « �•
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: 6)
WORK IN
PROGRESS: G.)0
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: \
S/molloy/forms 2014 Town of South Windsor INPSECTION 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, CT 06074 FEE .$25.00
Name of Firm i OQ AZic.,EI—'r G�/? S Phone No. 86o 9 8 3 7'3 2 6
Address of Firm / / 2 -e/1 vs .0te e- T S T' Zip Code
Location of proposed work / 3 C1 ftr.E G t y /Z
Describe fully nature of permit requested_ 7- G-elo rr V AAO-AC•9-
e'S 1' 'e/G-Ay'% w H-y Tjj /A/$ TiPc C. V.L I- ez�J -r~
Starting date_ /cF -.2 Call Before You Dig No o?o/ y yooa 9 e 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: El No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ 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 Indicate North This section to be filled out by Town
two copies of separate drawing
131 No. cuts
Est. Patch Size(s) sf
s
Est. Pvt.Thickness in.
I S Est. Patch Unit Price
P�oOast� �� I Est. Patch Cost$
sra� c�
f 5T
Est. Curb Replacement ft
N ' Est. Curb Unit Price
Est. Curb Cost$
K Ew x /2 Est. Sidewalk Replacement sf
Est. Sidewalk Unit Price
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting the Police Dept.and C.B.Y.D
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 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 STREE UT PERMIT MANUAL.
Signed: Print Name TC 1'1NSo+✓ Date: /-0-J? Y
Street Exc ation Permit 2014