HomeMy WebLinkAboutStreet Cut Permits 9999 Dart Hill Road (5) 1400235 TOWN OF SOUTH WINDSOR, CT
PENT NUMBER STREET CUT PERMIT
DATE: 08/08/2014
GIS ID:25809999 FEE: 0.00
MUNIS APPLICATION# 201401091 E-PIRATION DATE: 08/08/2015
APPLICANT LOCATION
NAME: GERBER CONSTRUG-7TION CO ADDRESS DART MILL ROAD
ADDRESS: I NUTMEG DRIVE _ OWNER TOWN pF SOUTH WINDSOR
ELLINGTON,CT 0602V� I540 SUS LIVAN AVE
SOU I'H�VINDSOR,CT 06074
PHONE 860-875-6684
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WORK DESCRIPTION: DAX-T Wf LU RD RECOIMSTRUCTION,"
ELLtNON RD TO NIEDERWERFER=RD DOWN EI� JECT
APPLICANT AGREES TO FURNISH THE IOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANC PENSES INCIIRREb BY THE.TOWN�ORIvIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE,APPLICANT IS"FAMILIAR WITH AND 0I!L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN 6F SOUTH WINDSOR'S=STREET GUT PERMIT MANUAL.
ISSUED BY ATE INSPLICTED INSPECTED BY
8/8/2014 9:54 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
,ao/ vlo91 APPLICATION FOR STREET EXCAVATION PERMIT jvooa3s
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SSU- ULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00
Name of Firm v 7xti— 0;'f11'-JL' r-� 6'�6oZo1� Phone No. Flo -9,f
Address of Firm l IV L f'• %► ,v Zip Code O 6O Z
Location of proposed work n ou a 58 9
Describe fully nature of permit requested Col-,s rU G a 6 /h AA
Starting date Z o Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN's CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATC
HT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
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No.cuts
Est. Patch Size(s) - sf
Tc) w 0 Est.Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est.Patch Cost$ J
Est.Curb Replacement J ft
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Est.Curb Unit Price$ /ft
Fames Iwgtv �d
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$ /r
( )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
(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 Q16T PERMIT MANUAL.
Signed: Print Name Date: bJ
Street Excavation Permit 2014