HomeMy WebLinkAboutStreet Cut Permits 16 Hanover Lane (2) 1400191 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 06/30/2014
GIS ID:39600016
MUNIS APPLICATION# 201400871 FEE: 25.00
EXPIRATION DATE: 06/30/2015
APPLICANT LOCATION
NAME: TELE-NETWORKS ADDRE 16—AI�IOVER LANE
ADDRESS: 31 BAKEWELL COLT
CRASTON,RI 0292) OWNER MCGRITH JAMES E&
LOVER LANE
PHONE 401-461-8420 = ;/ -6UTH VINDSOR, CT 06074
WORK DESCRIPTION: REPEL EXISTING GATV
APPLICANT AGREES TO FURNISH THE�'OWN OF SOUTH yVINDSOR" /THE AMO THE TOWN OF SO �T��BOND REQUIRED
SOUTH WINDSOR FOR ANY R FEIt1SES-INCURRED BY THE TOWI�7"FOI�14IAINTEN�ANCE OR REPAIR WORK IN
E
CONNECTION WITH THIS PERMIT AND THIv APpI ICANT IS FAMILIAR WITH A1yD Wks L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN(3Iy SQUTH WINDSWS,STREET CUT PERIVIIT MANUAL.
,."
ISSUED BY DATE SPECTED INSPECTED BY
6/30/2014 2:53 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I q VON CONTRACTOR:
LOCATION: /ftr
TYPE OF WORK: n17411Z
DATE INSP NEEDED: DATE INSP: i /
INSPECTED BY: P b
WORK IN
PROGRESS: e- o�k� 2 �c C' -7"✓
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: - l
S/2014 Town of South Windsor INPSEMON REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
1 TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CTo06074 FEE $25.00
Name of Firm -Q`� �►�G\\NOC�S Phone Nol W�'34G-23u 2
Address of Firma°-1j &b LAJ!0. 1 f coyk u 0 CQ ►cd Zip Code 0Z903
Location of proposed work 16 f-/z.,i,,vtr Ln fu ql &; Or
Describe fully nature of permit requested Y^eV(D.0 e -e Xs S k n Gz CA T V
Starting date Gf�'?f 1 y Call Before You Dig No a6 i6L.26o /77 8 -783
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
LN Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing �,s1
see ?-t+ac�)eol No.cuts
0 Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est. Sidewalk Replacement sf
Est.Sidewalk Unit Price
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 WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S TREET PERMIT MANUAL.
Signe Print NamQ( n\ r"" ��r� Date:
reet Excavation Permit 2014
50,
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NEW TRUNK
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