HomeMy WebLinkAboutStreet Cut Permits 24 Devonshire Drive (2) 1400225 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 07/31/2014
GIS ID:27900024 FEE: 25.00
MUNIS APPLICATION# 201401043 EXPIRATION DATE: 07/31/2015
APPLICANT = LOCATION
NAME: TELE-NETWORKS ADDRESS: -4:bE'%ONSHIRE DRIVE
ADDRESS: 31 BAKEWELL Co mwOWNED 1CTOMICHAEL&JESSICA
CRASTON,RI 0292 = = 24VNSHIRE DRIVE
PHONE 401-461-8420c�ut1Wdsor,CT 06074
WORK DESCRIPTION: REPIAG ATFViL
.,
APPLICANT AGREES TO FURNISH THI TORN OF SOUTH IINDS�1 THE AMOUN 1 OF BbND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AI LEI+I$ES-lNCYJRREU By I HI%TQWI OR Iv1AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS, WT ft Al D WTI L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN 7T SOUTH VIN'DRRYS-STREET CUTPEIIIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
7/3 1/2014 1 1:12AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: QQ 5 CONTRACTOR: ale- Q
LOCATION: _"1 &0 ble`00051i
TYPE OF WORK: 62
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: >>
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: ` S
S/2014 Town of South Windsor NPSEMON 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 06+0774 FEE $25.00
Name of Firm ' Nk- RWor; � p
Phone NoA-�a - 0 S- 2,302.
Address of Firm Vt Zip Codev2QQ
Location of proposed work _I I- GO Pic, n d r-
Describe fully nature of permit requested ke rlaLg Chill
Starting date ?_`3 1 " Call Before You Dig Noa'0kg31007$.-
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: P? 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
No.cuts
See A14cechec) 0 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$ /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
WINDSO STRE7r CUT PERMIT MANUAL.S i g n e Print Namz a�MQ � D'mV it R Date:
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