HomeMy WebLinkAboutStreet Cut Permits 25 Bridle Wood Road (2) 1400227 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/31/2014
GIS ID: 13800025 FEE: 25.00
MUNIS APPLICATION 9 201401045 - EXPIRATION DATE: 07/31/2015
APPLICANT LOCATION
NAME: TELE-NETWORKS „ ADDRERIIJLE WOOD ROAD
ADDRESS: 31 BAKEWELL CO i OW1E3� I�ANELA GEORGE T&LOUISE C
CRASTON,RI 0292 _ = 2IILE WOOD ROAD
, OUTH INDSOR,CT 06074
PHONE 401-461-8420 --
WORK DESCRIPTION: REVLA
Af
APPLICANT AGREES TO FURNISH THI O OF SOUTH�yFI�IDaOI� F1IE AMQUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR Ali#, �£PENES-INRIEDSYTHB TOWA-�YJR3VIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TIDE APPLICANT IS FAIaIII BAR WITH AI D WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TO SR'S ST Xiff°CUT PERMIT MANUAL.
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ISSUED BY j DA' - "SPECTED INSPECTED BY
7/3 1/2014 1 1:18AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR:
LOCATION: _ .� Ae'1 GQ e Lown,P
TYPE OF WORK: \a :f, C A-C
DATE INSP NEEDED: DATE INSP: r 13 ►5
INSPECTED BY: Ob
WORK IN
PROGRESS: 1 r 1.e r�.'e:i ujork,'' ;*ei"d f, �
1� &-'I .e L,.),Crj P
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: 1 DATE: 5/
S/2014 Town of South Windsor INPSECTION REPORT 14
l
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 0�60774 FEE $25.00
Name of Firm ' Neiwor Phone NoA-V + p 0' Nis 2302
Address of Firm V In Zip Code QU0
Location of proposed work 9-5-"5-7 Qr-,)lewd Pb
Describe fully nature of permit requested Lrkece C41U
Starting date -7-3 i 4 Call Before You Dig No,&-%nlq-10 6?t7/
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: QI No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
See f' y�4/ 0 Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price
Est. Patch Cost$
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$
( )
Applicant is responsible for contacting the Police Dept. and C.B.Y.D ( ) Cash Check#
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 WI.TU AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S` TREET T JERMIT MANUAL.Z
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r� Date:
2014
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