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HomeMy WebLinkAboutStreet Cut Permits 113 Steep Road (2) 1400337 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 11/25/2014 GIS ID: 85500113 FEE: 0.00 MUNIS APPLICATION# 201401695 EXPIRATION DATE: APPLICANT LOCATION NAME: YANKEE GAS ADDRESS: 1"13sTE P ROAD ADDRESS: 112 PROSPECT HILL RD";= OWNER:" ;BEGER ?VILLIAM&SUSAN EAST WINDSOR,CT--05088 113 =STEP ROAD INDSOR, CT 06074 PHONE 860-292-2242 WORK DESCRIPTION: EXCAVATE TO INSTALL GAS SERVICE FRgM CURB O HOUSE APPLICANT AGREES TO FURNISH 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 THE APPLICANT IS 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. ISSUED BY DATE INSPECTED INSPECTED BY 1 1/25/2014 1 1:54AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** ------ ---------- TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: / 0 03 31 CONTRACTOR: LOCATION: 113 54&e w ®� TYPE OF WORK: n 5 G c e DATE INSP. NEEDED: DATE INSP: INSPECTED BY: ft> WORK IN PROGRESS: ✓� �sS ns 1�4c'c�> ��� F''6�1t ti s s � SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: `N- DATE: \� S/molloy/forms 2014 Town of South Windsor INPSECiION REPORT 14 APPLICATION FOR STREET EXCAVATION PERMIT Appl. No. TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT 1540 SULLIVAN AVENUE Date: SOUTH WINDSOR,CT 06074 FEE $25.40 Name of Firmi�� CT Phone No. ? 6'0 -Z 9 2 ^ 2-.5�; Address of Firm_ C ( 2, S �.Zs c - I JL p ,� iD Zip Code O 6 C> R8 Location of proposed work_L1 �- . p c7 K 1(2-b Describe fully nature of permit requested fi r'�3 Y,� `I� I-O / �Sc' l/ P& S I c(F tr it-D Al C R..o s.s 7714 p ,p Starting date___(_ Z --/ —/4f Approx.time for completion 7-3 b Call Before You Dig No._Z-O f t j ct7 6 00 'Z Existing Water Supply: ❑Public Water Well Existing Sewage Service: ❑Public Sewer ❑ Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT;INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. .Show sketch of proposed work or furnish This section to be filled out by two copies of separate dra%lr'lg Indicate.North Town.of.South Windsor No.cuts I Est. Patch Size(s) sf 3 Est.Pvt.Thickness in. J Est.Patch Unit Price$ /sf Est.Patch Cost$ G rn Est.Curb Replacement ft O Est.Curb Unit Price$ /R d � Est.Curb Cost$ Est.Traffic Unit Cost$ fir Est.Traffic Control$ ©-q If it.,L-Oro Amt.of Deposit$ Total Due$ Cash ( )Check# Applicant is responsible for contacting Paid By the Police Dept.and C.R.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: ��a-.-- Date: Title:. �-r'7 /� S� �•U C-9-/U aV 7-.�cly 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 Zf