HomeMy WebLinkAboutStreet Cut Permits 541 Quarry Brook Driv (2) 1400259 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/03/2014
GIS ID:74100541 FEE:MU 25.00
NIS APPLICATION# 201401228 EXPIRATION DATE: 09/03/2015
25.00
APPLICANT = LOCATION
NAME: COLLA CONSTRUCT ION CO,INC ADDRESS: 541 QUARRY BROOK DRIVE
ADDRESS: P O BOX 291 OWNER. NOWAI WILLIAM K&CATHERINE M S
WINDSOR LOCKS,.T 66Q,96 541' IRRY BROOK DR
SOUTH WINDSOR,CT 06074
PHONE 860-254-5670
WORK DESCRIPTION: D R W EWE "
APPLICANT AGREES TO FURNISH THE TO WIC OF SOUTH WINDSOR THE AMOv OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANIf:XPENSES INCURRED 8Y THE TOWN FOR1l!IAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS 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.
- 1 157
ISSUED BY DATE INSPECTED `
INSPECTED BY
9/3/2014 11:15 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: C O/Za Ce n SI .
TYPE OF WORK: >r i v-eLJa N
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: /' �� DATE: ' (,
S/2014 Town of South Windsor WsECtION 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 06074 FEE $25.00
Name of Firm 6 Gi "/ "7)!011 610 �ll. Phone No. &0 ^
Address of Firm PO Zcckcz 27-- s 4c®2' Zip Code
Location of proposed work A//
Describe fully nature of permit requested ri[
OtA u
Starting date Call Before You Dig No J
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: El No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut ElCurb Cut ❑ Sidewalk Cut
�
12' Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
0 No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price
Est.Curb Cost$
Est.Sidewalk Replacement sf
/►i Est.Sidewalk Unit Price$ /sf
c►_ 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 SOUT-W 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 CUT R MANUAL. 1
Signed: Print Name ✓C �ca��s4� Date:
Street cavation Permit 2014