HomeMy WebLinkAbout9999 Good Hill Road 1400048 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 04/08/2014
GIS ID: 36009999 FEE: 25.00
MUNIS APPLICATION# 201400341 = 1�XPIRATION DATE: 04/08/2015
APPLICANT LOCATION
NAME: TELE-NETWORKS
ADDRESS: 31 BAKEWELL COURT , --ADDRESS.,
9}99 FOOD HILL ROAD
OWN1R TOWN OF SOUTH WINDSOR
CRASTON,RI 0292 - 10 STLLIVAN AVE
SOI7TI 'WINDSOR,CT 060742734
PHONE 401-461-8420
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WORK DESCRIPTION: REP E ISTTINGIC7-11
APPLICANT AGREES TO FURNISH THR-kTOW N OF 50UTH- NDS-0R HE-A1�IpUNT QF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY=I XPEN ES INCURREb BY T—RE TOWI I FOB"MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMI IAR KITH ANC 4 iLL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDS"STREET-CU TPERMIT MANUAL.
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ISSUED BY DATE INSPECTED INSPECTED BY
4/8/2014 11:3 8 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 0 ®� CONTRACTOR: O
LOCATION:
a
TYPE OF WORK: C A-'r
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: Qb
WORK IN
PROGRESS:- i `-
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
�T)O,,WNN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 0�6+0774 FEE $25.00
Name of Firm ' IV"c 1WOr"� Phone NoA M. 04S. 2,301
Address of Firm V h `e Zip CodeoZgo
Location of proposed work ` C^ 1 Io OQ
ACA IF-
Describe fully nature of permit requested ' �'}��
Starting date iN t9e r 6 F- ik R- �� Call Before You Dig No,-: lOk + 140,4V9
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: 0 NO Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
Q + No.cuts
4 S�` /A 0 Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price
Est. Patch Cost$
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$ /hr
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 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' STREET CUT PERMIT MANUAL. nn , ( � , /�
Sign Print Namzamos 1l NM X 6k Date: —1 `01- C "'
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