HomeMy WebLinkAboutStreet Cut Permits 181 Newmarker Raod (2) 1400170 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/16/2014 ;-00-1
GIS ID; 63300181 � FEE: 25.00
MU
MS APPLICATION# 201400766 EXPIRATION DATE: 06/16/2015
f ,
APPLICANT LOCATION
NAME: ADVANCED CONST TCTI N ADDRESS -18~-NI WMARKER ROAD
��
ADDRESS: 5 CHESTNUT HILL RO� � e
AVIDE EDWARD D&CAROL A
STAFFORD SPRING6II 6
81 KE*MARKER RD
PHONE 860-519-8442
-�% j OUT-11 INDSOR, CT 06074
WORK DESCRIPTION: IN§TA I� ACEI I
APPLICANT AGREES TO FURNISH THftO
IIAMlI la 1ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY&PI i Ise� :I IPIE�T9 LFOI vIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TFP ICAIT ISA��t V�TT1 ALLp L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN SCU WfII3SR R1TIdTf�ERIIT MANUAL.
ISSUED BY D TE S TED INSPECTED BY
6/16/2014 11:37 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
i,
i
is
-"%
%y 3-0
yi
ii/'
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /9'00 /70 CONTRACTOR:
LOCATION: /g/ AktJ M Lj yr Yo(2 f_QC-U
TYPE OF WORK: n �-
DATE INSP NEEDED: DATE INSP: i
INSPECTED BY: &D
WORK IN
PROGRESS: "14Va"CeJ C a415 LcL,, 'i ,, re/,2liareJ C/1--T—C/ Z.,
+11 eso or,on,k-a
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C,vv--- DATE:
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT Permit No,
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074 -"'---
FEE $25.00
Name of Firm *4 Gy' 1 r Phone No, �C
Address of Firm ��(g a r tir
Location of proposed work ' f-S-�T Zip Code
Describe fully nature of permit requested- 1 A e-1-r i f y P n 1 cr
Starting date_ r-, ,Q Approx. time for completion
Call Before You Dig No. Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
Show sketch of proposed work or furnish ��-
two copies of separate drawing This section to be filled out by
Indicate North Town of South Windsor
No. cuts
0
Est. Patch Size(s) sf
Est. Pvt. Thickness in.
Est. Patch Unit Price$_ /sf
Est. Patch Cost$..
( Est. Curb Replacement ft
I Est. Curb Unit Price$_________/ft
J` Est, Curb Cost$
' Est. Traffic Unit Cost$_____ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$...
( )Cash ( )Check#
Applicant is responsible for contacting Paid a the-Police Dept.and C.B.Y.D. y
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:_ Date: Z/�0
Title:
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