HomeMy WebLinkAboutStreet Cut Permits 90 Bayberry Trail (2) 1400169 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 06/16/2014
GIS ID: 08100090
MUNIS APPLICATION# 201400765 s./� FEE: 25.00
JAN, PIRATION DATE: 06/16/2015
APPLICANT y,
LOCATION
NAME: ADVANCED CONSTJCTI�N �
ADDRESS: 5 CHESTNUT HILL RI - � QDDRI;S ( 1ABERRY TRAIL
-1LOUR E CARLINE TRUSTEE
STAFFORD SPRING S, Z
0 IYERRY TRAIL
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PHONE 860-519-8442 ;� DSOR, CT 06074
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WORK DESCRIPTION: INS I�� �fi jam _ ' All
APPLICANT AGREES TO FURNISH THIf O QpLfTL
AMTF IND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FORA 3-Pm-'s Aftma INTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TI tPICANT I� R ;
FOR PERMITS AS OUTLINED IN THE TOWN L ABIDE BY THE RULES AND REGULATIONS
IT MANUAL.
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ISSUED BY
J DATA RpmTED INSPECTED BY
6/16/2014 11:20 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /YO®/L CONTRACTOR: acj,ibneed C�n517uc =ior�
LOCATION: !2L O &riff—t%ro'x ,
TYPE OF WORK: f
DATE INSP NEEDED: DATE INSP: a /
INSPECTED BY: TA
WORK IN
PROGRESS: :`�V��c_e dUt9u �r ����a D�cl ( A=✓U
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: V DATE: I ' I
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 $25.00
Name of Firm Gr' r Phone No. i 8�/L�
Address of Firmer h 6::51,�,, h , rn, `.� �Qti2L L- ,4, S r-1 Zip Code
Location of proposed work 12=
Describe fully nature of permit requested
Starting date_ /.. r[ Approx. time for completion_
Call Before You Dig No. Existing Water Supply: ❑ Public Water Well
Existing Sewage Service: ❑ Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS, THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish --
two copies of separate drawing This section to be filled out by
Indicate North Town of South Windsor
0 No. cuts
Est. Patch Size(s) sf
9� Est-'Pvt. Thickness in.
Est. Patch Unit Price$_ /sf
Est. Patch Cost$
Est. Curb Replacement It
Est. Curb Unit Price$ /ft
Est. Curb Costs
Est. Traffic Unit Cost$
iEst.Traffic Control$ _
Amt.of Deposits
Total Due
( )Cash ( )Check#
Applicant is responsible for contacting Paid By
the-Police Dept.and C.B.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: �)lt'V Date:
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