HomeMy WebLinkAboutStreet Cut Permits 486 Quarry Brook Driv (2) 1400264 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/04/2014
GIS ID: 74100486 FEE: 25.00
MUNIS APPLICATION# 201401238 EXPIRATION DATE: 09/04/2015
APPLICANT = LOCATION
NAME: TELE-NETWORKS ADDRESS. 4 &QUARRY BROOK DRIVE
ADDRESS: 31 BAKEWELL COUAW OWNER = MCCARE GEORGE J&PATRICIA I
CRASTON,RI 0292 4$6 QUARRY BROOK DR
SOU H INDSOR,CT 06074
PHONE 401-461-8420 = _
WORK DESCRIPTION: REMAGE IIXISTING CATV
APPLICANT AGREES TO FURNISH THE TOwN OF SOUTH WINDSOR THE AMOUNT OF B{7ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANYI fPENSES INCURRED'BY THE T6WN-F6R4MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE_ APPLICANT IS FAMILIAR WITH ANiI WII L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN CIF SOUTH WINDSO '.S S/TREET CUT PERMIT MANUAL.
ISSU BY D TE INSPECTED INSPECTED BY
9/4/2014 8:44 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: /P- berwof)_S'
LOCATION:
TYPE OF WORK: _"_na cg GXl y-(n a (5A I V
DATE INSP NEEDED: DATE INSP: 13 15_
INSPECTED BY: -6S)
WORK IN
PROGRESS: 1 ,�l�l� c�ilk ��r�� C�c� ��� �'fA7y
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/molloy/forms 2014 Town of South Windsor INPSEMON 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 060074 FEE $25.00
Name of Firm TPAP 4j&w()(�--S Phone No.'s` 83J -34G-236 2
Address of Firmc3'1" 6C0 I,, &(-4 enykcu vi a Zip Code 02QU3
Location of proposed work QQ
Describe fully nature of permit requested 1^f&,C_e f X�S- 1k n 61 (A I V
Starting date �-S lti/' Call Before You Dig Noa6i�L 3&c o (i-�7
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: Do No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
Se( aC�e�l No.cuts
0 Est. Patch Size(s) sf
Est. Pvt. Thickness in.
Est. Patch Unit Price$ /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
WINDSOR'S TREEr��IT MANUAL. `` V�((�u� p
Signe : Print NameJ(� O r '�° �� �G� Date:
reet Excavation Permit 2014
�01 y 3 600�f.27
502 V/L 486 �Aec
480 472
-pq\�O- P/0*,0
cr
500 feeder losing 6 under the ro d w
cY) -
�---- VI
OOI deder--lo in 4_A f
.SOOp3
r
_
44, _ 0 o
R 1 � --
S
5%b R 1 3..1-0;......_....._.----- _ .SOOP3
491
Q�
SWB1315 ,` I g
FMB 1 GPJ
4 B1301
16/21 54/37 479
17/17 32/29
1152' J/J
O 458 05/2 4/2
0 83.1 T
40 1
31
b/('b
41
�%b