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HomeMy WebLinkAboutStreet Cut Permits 170 Orchard Hill Driv (3) 1400059 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 04/14/2014 GIS ID: 66900170 FEE: 25.00 MUNIS APPLICATION# 201400372 EXPIRATION DATE: 04/14/2015 APPLICANT LOCATION NAME: AIROLDI'S INC. gr ADDRESS: 17D OIHARD HILL DRIVE ADDRESS: P O BOX 71 OWJ`IER MAZARO VINCENT J&DEBORAH D SOUTH WINDSOR,_�T -J OR&HARD HILL DRIVE Sough Windsor,CT 06074 PHONE la WORK DESCRIPTION: DRIVE VVA - / THE DRAIN LAYER ASSIGNED TO THI§ EIMIT HAS AV Lj LIGEI<ISE ISSUED,BY THE/STATE AND HEREBY AGREES TO ALL THE TERMS AND CONDITIONS SET FOI T IK THE ATTACHED-`CONDITIONS'. ALL 1 ORK SHALL BE IN ACCORDANCE WITH THE TOWN OF SOUTH WINDSOR STANDAIDS,ALL OSHA REQUIREMENTS,AND THE ATTACHED CONDITIONS. ISSUED BY DATE INSPECTED INSPECTED BY 4/14/2014 9:18 AM TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: l BUD S CONTRACTOR: i'( 0 '_S LOCATION: 117 0 o le cha► d 1 11 1)r J V F' TYPE OF WORK: r'�u e Loa DATE INSP NEEDED: DATE INSP: INSPECTED BY: t3i� WORK IN PROGRESS: ,r�..� -� S SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: W/2007 Town of South Windsor INPSECTION REPORT 07 APPLICATION FOR STREET EXCAVATION PERMIT Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No. TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm Nf I Phone No. (�d`_as -gt 7 G Address of Firm P40 80kZip Code d Location of proposed work_A ® �� Describe ful'I na�permit requested Starting date b'�© Call Before You Dig No PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Check Applicable: ❑/No Pavement,Curb or Sidewalk Cut El Pavement Cut El Curb Cut ❑ Sidewalk Cut lzi Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic Show sketch of proposed work or furnish Indicate North This section to be filled out by Town two copies of separate drawing No.cuts Est. Patch Size(s) sf Est. Pvt.Thickness in. Est. Patch Unit Price$ /sf Est.Patch Cost$ Est.Curb Replacement ft (� Est. Curb Unit Price$ /ft Est.Curb Cost$ __ Est. Sidewalk Replacement sf Est.Sidewalk Unit Price �p Est.Sialk Cost$ Est.Traffic Hours hr �O \� 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 ST��U�P RMI-�.�VIANUAL. Signed:. Print Name tC.Ylol� I he Date: g Street Excavation Permit 2014