HomeMy WebLinkAboutStreet Cut Permits 97 Sally Drive (2) 1400213 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/21/2014
GIS ID:79500097 FEE: 25.00
MUNIS APPLICATION# 201400985 EXPIRATION DATE: 07/21/2015
APPLICANT = LOCATION
NAME: ADVANCED CONSTgUCTI6N ADDRESS: 97 SALLY DRIVE
ADDRESS: 5 CHESTNUT HILL (3Ah- - OWNER SEBA*IAO JOSE 0&SUSAN V
STAFFORD SPRINq __C 076 97 -SALLY DRIVE
86VUl INDSOR,CT 06074
PHONE 860-519-8442
WORK DESCRIPTION: INSALI REPLACE CAFV
APPLICANT AGREES TO FURNISH THSTOWN OF SOUTH WINDSOR THE AMOUNT O--BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY-EXPENSES INCURRED'BY THE TOWN FORVIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND Tft APPLICANT IS FAMILIAR WITH AND WELL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF"SOUTH WINDSR'S STREET`CUT PERMIT MANUAL.
J
ISSUED BY DATE INSPECTED INSPECTED BY
7/21/2014 12:24 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I LA DU 13 CONTRACTOR:
LOCATION: Q Z Sa j DL\► '
� � �
TYPE OF WORK: 1 � � �-�
DATE INSP NEEDED: DATE INSP: l i
INSPECTED BY:
WORK IN
PROGRESS: AO�c,��td
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
i
INPUT: — DATE: - S
S/2014 Town of South Windsor INPSECTION REPORT 14
I
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 $25.00
Name of Firm '� Gy� '- S n
Sey Phone No.
Address of Firm S tiC Zip Code
Location of proposed work
Describe fully nature of permitPaustedt� -1
Starting date_ hit 0
Approx• time for completion__�i2o
Call Before You Dig No. Existing Water Supply: El Public Water
❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE:THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Shaw sketch of proposed work or furnish
two copies of separate drawing This section to be filled out bar
Indicate North Town of South Windsor
No. cuts
0
Est. Patch Size(s) . sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ lsf
Est. Patch Cost$ _
YL
Est. Curb Replacement ft
Est. Curb Unit Price$__eft
4 Est. Curb Cost$
Est.Traffic Unit Cost$- _ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due
O Cash ( )Check#
Applicant is responsible for contacting Paid 8 the Police Dept.and C.B.Y.D. Y
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND RE
QUIRED AND TO
TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR R PIAIR WORKHIN
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: �2e, //fillti'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